MedicaidPrior AuthMedium impact
http://www.dpw.state.pa.us/omap/provinf/mabull/070501.asp
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Psychiatry·Provider Bulletin
Effective date
Aug 1, 2005
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is extending authorization periods for Behavioral Health Rehabilitation (BHR) services for children and adolescents with autism and developmental disorders from 4-6 months to up to 12 months. Comprehensive re-evaluations are now required annually instead of every 4-6 months.
Action Required
By August 1, 2005: Billing teams serving Pennsylvania Medicaid patients under 21 with autism/developmental disorders must update authorization tracking systems to reflect 12-month authorization periods instead of 4-6 months. Update re-evaluation scheduling to annual intervals. Maintain treatment plans and documentation in clinical records for submission with reauthorization requests.