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Comprehensive ABA Billing Checklist for Providers by State

Select the State:
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Select the Payor:
Anthem
Virginia
Anthem
Ohio
Cigna
Massachusetts
HAP Alliance
Michigan
BCBS MA
Massachusetts
Virginia Premier Health Plan(Medicaid)
Virginia
United Behavioral Health
Tennessee
Western Sky Community Care
New Mexico
Wellcare Health Plan Medicaid KY
Kentucky
WebTPA
Florida
Wellcare
New Jersey
United Medical Resources(UMR)
Nevada
Virginia Premier
Virginia
United Healthcare MSCAN
Mississippe
United Healthcare Community Plan Tennesse
Texas
United Healthcare Community Plan
Tennessee
United Healthcare Community Plan
Pennsylvania
Tricare West Region
Missouri
United HealthCare
Texas
United Health
New York
United Health Care Golden Rule
Texas
Magnolia
Mississippe
United Behavioral Healthcare
Washington
United Behavioral Health
Virginia
United Behavioral Health
North Carolina
United Behavioral Health
New Mexico
United Behavioral Health
Nevada
United Behavioral Health
Michigan
United Behavioral Health
Maryland
United Behavioral Health
Georgia
United Behavioral Health
Florida
Unicare
Massachusetts
UMR
Tennessee
UMR
New Mexico
UMR
New York
UMR
New Jersey
UMR
Nevada
UMR
Mississippe
UMR
Illinois
UMR
Georgia
UHC
Washington
UMR
Florida
UHC
Pennsylvania
UHC
Tennessee
UHC
Ohio
UHC
New York
UHC
New Jersey
UHC
Missouri
UHC
Mississippe
UHC
Kentucky
UHC
Georgia
TUFTS
Michigan
TUFTS Health Plan
Massachusetts
TUFTS
Massachusetts
TrustMark Health Benefits
Nevada
Trust Mark
Maryland
Trust Mark
North Carolina
Tricare
Virginia
Tricare
Pennsylvania
Tricare
Tennessee
Tricare
Mississippe
Tricare
Michigan
Tricare
Maryland
Tricare
Illinois
Tricare for Life
Texas
Tricare East
Virginia
Tricare East Tricare East Region Claims (Tricare)
Texas
Tricare East
Tennessee
Tricare East Standard
Texas
Tricare East
North Carolina
Tricare East
New York
Tricare East
New Jersey
Tricare East
Mississippe
Tricare East
Maryland
Tricare East
Michigan
Tricare East
Illinois
Tricare East
Georgia
Tricare
Florida
Tricare East
Florida
Sunflower STA
Missouri
Sierra Health & Life
New Jersey
Silver Summit Health
Nevada
Sierra Health & Life
Nevada
Silver Summit
Nevada
Sierra Health
New Jersey
Scott & White Health Plan Standard
Texas
Regence Blue Shield Standard
Washington
Regence Blue Shield Boeing Traditional Medical Plan
Washington
Quest Behavioral Health
Tennessee
Priority
Michigan
Quest Behavioral Health
Pennsylvania
Presbyterian Centennial(Mg)
New Mexico
Presbyterian Centennial
New Mexico
Premera BC Standard
Washington
Premera BC Microsoft
Washington
Oxford Health Plan
New York
Premera BC Amazon
Washington
Physicians Health Plan(PHP)
Michigan
Peach State Health Plan Medicaid GA
Georgia
Optum
Texas
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California

State selected

12

No of Payors

Checklist
Mandatory Fields (Y/N)
Patient Full Name
Yes
Patient DOB
Yes
Rendering Provider Full name
Yes
Rendering Provider Credential (BCBA/RBT/BCaBA)
Yes
Rendering Provider Signature (BCBA/RBT)
Yes
Supervising Provider Name and Signature (If Rendering provider RBT)
Yes
Signature Date and Time
Yes
Service Location (POS)
Yes
Session Date and Time
Yes
CPT and Diagnosis code should present on Medical records
Yes
Detail description of service performed
Yes
Treatment plan if required (Indicates Duration of service) or Progress Notes
Yes
Should Supervising provider be present at the time of service
Yes
Patient/Subscriber Signature required or Not
No
Do we have any separate guidelines to be followed for the plans HMO, PPO and POS
Follows - CMS Guidelines
Additional Information
No
Was there any change in Modifiers usage or in guidelines- HO, HM, HN, GT, 95
No
Insurance Phone #
18444-966-0298
Download Checklist

Disclaimer: The information contained in these checklists was last revised on May 2024. Users are advised to verify the current billing guidelines directly with their respective insurance providers, as policies are subject to change without notice.