EFFECTIVE 2/1/2022: Applied Behavior Analysis Services

Date: 01/14/22

Beginning February 1, 2022, Superior HealthPlan will be providing Applied Behavior Analysis (ABA) services as a new Medicaid managed care benefit for individuals with Autism Spectrum Disorder (ASD).  The symptoms of ASD include restricted, repetitive patterns of behavior, interests, or activities and shortcomings in social communication and social interaction. These symptoms usually start in early childhood.

What Services are Provided?

ABA services must be prior authorized through Superior HealthPlan as a medically necessary service, required to treat, correct or improve the member's condition. A diagnosis of autism spectrum disorder alone does not support the medical necessity of ABA.  Licensed Behavior Analyst (LBA) is a new Medicaid provider type that will be providing these services.  ABA services include ABA initial evaluation, re-evaluation, individual treatment, group treatment, parent/caregiver/family education and training, and interdisciplinary team meetings.  Please contact your/your child’s doctor, visit Superior’s website, or call Superior’s Member Services department to locate a Medicaid enrolled LBA provider in your area available to deliver these services.

Who is Eligible for Services?

Medicaid managed care members in the STAR, STAR Health, STAR Kids and STAR+PLUS Medicaid for Breast and Cervical Cancer (MBCC) Program under the age of 21 with Autism Spectrum Disorder (ASD) are eligible for these services, if medically necessary.

For more information, visit Superior’s Autism Help webpage.