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Prior Authorization Resources

Checklist for Applied Behavioral Analysis (ABA) Requests:

The Following Five Items are Required:

  1. A diagnosis of autism spectrum disorder or stereotypy with self-harming behavior from a physician.
  2. An order for ABA treatment from a physician (or appropriately qualified Clinical Psychologist).
  3. An Assessment and Treatment Plan formulated by a licensed ABA therapist
  4. Form KF-004
  5. Form KF-005

Please note an assessment that refers to a doctor that gave a child a diagnosis of autism is not enough. There must be a documented diagnosis and order from the physician.