MedicaidPrior AuthMedium impact
Applied Behavioral Analysis - MEDICAID - LOUISIANA (Revised)
Humana·LA · Pediatrics, Psychiatry, Family Medicine·Medicaid
Effective date
Feb 11, 2026
We identified it
Jun 24, 2026
Summary
Louisiana Medicaid Applied Behavior Analysis (ABA) policy has been revised with updated coverage criteria, prior authorization requirements, and qualified healthcare professional definitions. The policy requires a two-step prior authorization process and comprehensive diagnostic evaluation for members under 21 with autism spectrum disorder or related conditions.
Action Required
Before February 11, 2026: Billing teams serving Louisiana Medicaid members must update ABA therapy workflows to require two-step prior authorization process: first for functional assessment and behavior treatment plan development, then for ABA therapy services delivery. Update systems to verify members are under 21 years old, have comprehensive diagnostic evaluation by qualified healthcare professional, and include IEP documentation when services are school-based. Claims without proper prior authorization will be denied.