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New ABA medical policy to replace InterQual criteria
February 28, 2022

This article is for behavior analysts and clinical psychologists caring for our members

We want to remind you that on March 1, 2022, we’re replacing InterQual®′ criteria for applied behavior analysis with the new simplified and clarified Applied Behavior Analysis (ABA) Medical Policy 091. We communicated this upcoming change to you in our February 2022 medical policy announcements.

Prior authorization will still be required for patients with commercial health plans (HMO, PPO, Indemnity) and Federal Employee Program plans. There are no changes to the way you will request prior authorization.

To view the new medical policy when it is released, visit our Medical Policy page.

How to request authorization for ABA services

As a reminder, you can submit your prior authorization requests using one of these methods: