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MedicaidPrior AuthMedium impact

25-108 Access Applied Behavioral Analysis (ABA) Forms Online

Health Net·CA · Pediatrics, Psychiatry·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net California now requires specific ABA forms for Applied Behavioral Analysis services, with different forms required for Medi-Cal vs Commercial members. All ABA services require prior authorization using designated forms available in the Provider Library.

Action Required

Action needed
Immediately: Billing team must access Health Net's Provider Library to download correct ABA forms. Use ABA Recommendation and Referral Form for Medi-Cal members, Confirmation of Diagnosis ASD form for Commercial members, and Prior Authorization Request Form for all ABA services. Ensure licensed physicians or psychologists complete required forms before submitting ABA service claims. Claims will be denied without proper prior authorization.