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Update to a Prior Authorization Requirement for Autism Services

Effective date: April 1, 2025

Call to action: The purpose of this communication is to inform providers that effective for dates of service on or after April 1, 2025, a prior authorization requirement will be updated for Autism Services for Texas Medicaid.

Applied Behavior Analysis (ABA) 90-day Treatment Extension
The prescribing provider signature will no longer be needed on the completed Comprehensive Care Program (CCP) Prior Authorization Request Form when requesting the 90-day treatment extension.

The initial treatment plan must be signed and dated by a prescribing provider for the full 180 days. The 90-day treatment extension is to continue the same treatment frequency or submit new goals, if needed.

Providers may refer to the Texas Medicaid Provider Procedures Manual (TMPPM), Children’s Services Handbook, subsection 2.3.11.4, “ABA 90-day Treatment Extension,” for additional information.

Next steps: Providers should share this communication with their staff. 

If you have any questions, please email Provider Relations at:providerrelations@texaschildrens.org 

For access to all provider alerts, log into:  www.texaschildrenshealthplan.org/provideralert