How do I Submit a Prior Authorization for Aba Therapy to Mo Healthnet?

Submitting a prior authorization for Applied Behavior Analysis (ABA) therapy to MO HealthNet is a critical step to ensure your child’s services are covered. We understand this process can feel overwhelming, so we provide hands-on support to help you navigate the paperwork.

To submit a request, you must follow these essential steps:

1. Gather Required Clinical Documentation:

We help you compile a complete packet, which must include a formal autism diagnosis (ICD-10 code F84.0) from a licensed physician or clinical psychologist, a BCBA-written treatment plan with specific goals and recommended hours, a letter of medical necessity, and signed consent forms.

1. Identify Correct CPT Codes:

The request must include standardized service identifiers. Common codes requiring authorization include 97151 (Assessment), 97153 (1:1 RBT therapy), and 97155 (BCBA supervision).

1. Choose a Submission Method:

• Online Portal: You can submit forms electronically via the official Medicaid website for instant confirmation and easier tracking.
• Mail: You may send a physical packet via certified mail with a return receipt to maintain a paper trail.

1. Track the Review Timeline:

Once submitted, MO HealthNet typically reviews requests within 14 to 30 calendar days. We recommend setting a reminder to follow up if you have not received a status update after two weeks.

Our team is here to provide insurance verification and assistance with this process to help your child achieve real progress through a personalized therapy plan. While we assist with the paperwork, please note that results may vary and you should always verify your specific insurance coverage.

Disclaimer: Information on this site is not a substitute for professional medical advice. Consult a healthcare professional for diagnosis and treatment.

• How to Get MO HealthNet Autism Prior Authorization