MedicaidBilling CodesHigh impact
BT202401: IHCP clarifies prior authorization requirements for ABA therapy services
Indiana Medicaid (IHCP)·IN · Psychiatry·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
IHCP clarifies that ABA therapy prior authorization requests do not require modifiers, but billing claims must include specific U modifiers (U1, U2, U3) to indicate provider credential level. Claims without the required procedure code-modifier combinations will be denied starting January 1, 2024.
Action Required
Immediately: Billing team must update ABA therapy claims to include required U modifiers - U1 for RBT, U2 for BCaBA, U3 for BCBA/BCBA-D/physician/HSPP providers. Update billing system rules to require modifiers on all ABA procedure codes. Review reference bulletin BT2023169 for complete procedure code-modifier combinations. Claims submitted without proper modifiers will be denied.