High impact
Applied Behavior Analysis - MEDICAID - OKLAHOMA (New)
Humana·Effective Sep 16, 2026
Humana has released a new Applied Behavior Analysis (ABA) coverage policy for Oklahoma Medicaid effective 09/16/2026. The policy establishes coverage limits for ABA initial assessments (24 units/6 hours) and reassessments (16 units/4 hours every 6 months), with defined exception criteria for complex cases including regression, comorbid conditions, major treatment changes, severe behaviors, language barriers, and multi-system coordination. Billing teams must implement prior authorization requirements and ensure documentation supports medical necessity for any units exceeding standard limits.