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Provider Letter 2024-25: RE: Applied Behavioral Analysis Policy Revisions

Oklahoma SoonerCare·OK · Psychiatry, Pediatrics·Provider Letter
Effective date
Oct 25, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Oklahoma Health Care Authority implemented comprehensive revisions to Applied Behavioral Analysis (ABA) services policy effective October 25, 2024. Key changes include updated documentation requirements for behavior intervention plans, new geographic restrictions requiring contracted providers to reside within Oklahoma or within 50 miles of the border, and revised frequency/duration limits for ABA services based on medical necessity.

Action Required

Action needed
Immediately: ABA providers must review and implement new documentation requirements for behavior intervention plans, extension requests, and billing guidelines. Verify all contracted ABA providers meet the new geographic requirement (must reside within Oklahoma or within 50 miles of state border). Update billing processes to comply with revised frequency and duration limits for ABA services. Review service limitation clarifications and physical restraint documentation requirements. Contact OHCA provider helpline at 800-522-0114 for questions.