MedicaidPrior AuthHigh impact
Precertification Requirements for Behavioral Health and ABA Services
Missouri Medicaid (MO HealthNet)·MO · Psychiatry, Pediatrics·Provider Notice
Effective date
Nov 22, 2022
We identified it
Jun 20, 2026
Summary
Effective immediately, all ABA services require precertification, and psychotherapy services for children ages 3-20 require precertification beyond the first 14 hours. All behavioral health services for children birth through 2 years also require precertification except diagnostic evaluations.
Action Required
Immediately: Billing team must update system to require precertification for all ABA services before submission. Implement precertification checks for psychotherapy services after 14 hours for children ages 3-20, and for all covered services (except diagnostic evaluation) for children birth through 2 years. Update encounter forms and staff workflows to verify precertification status before service delivery. Claims submitted without required precertification will be denied.