MedicaidAdministrativeMedium impact
BT2024194: IHCP clarifies ABA documentation requirements and updates provider enrollment requirements
Indiana Medicaid (IHCP)·IN · Psychiatry·Enrollment
Effective date
Dec 18, 2024
We identified it
Jun 19, 2026
Summary
IHCP updated ABA therapy documentation requirements and provider enrollment rules effective December 18, 2024. New provider specialties were created for Bachelor's level (BCaBA) and RBT providers, with rendering provider NPI requirements starting April 1, 2025.
Action Required
By December 18, 2024: ABA therapy providers must update enrollment classifications as existing specialty 615 becomes high-risk requiring fingerprint background checks and site visits. Enroll new Bachelor's level (specialty 624) and RBT (specialty 625) providers with appropriate certifications. By April 1, 2025: Billing team must ensure rendering provider NPI on ABA therapy claims aligns with procedure code modifiers indicating provider level. Maintain required documentation (CDE, behavior assessments with three core instruments, treatment plans) available within 72 hours of request.