MedicaidPrior AuthHigh impact
25-110 Access Applied Behavioral Analysis (ABA) Forms Online
Health Net·CA · Pediatrics, Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California has made Applied Behavioral Analysis (ABA) forms available online in the Provider Library. Three different forms are now required for ABA services depending on member type: a Recommendation/Referral form for Medi-Cal members, a Prior Authorization Request form for all members, and a Confirmation of Diagnosis form for Commercial members.
Action Required
Immediately: Behavioral health providers and pediatricians must access the Provider Library online to obtain the correct ABA forms. Use the ABA Recommendation and Referral Form for Medi-Cal members, the Prior Authorization Request Form (with updated treatment plan) for all ABA services, and the Confirmation of Diagnosis form for Commercial members. All ABA services require prior authorization and appropriate form submission before service delivery. Failure to submit proper forms and obtain prior authorization will result in claim denials.