MedicaidDocumentationHigh impact
BT202662: IHCP issues additional ABA guidance for providers
Indiana Medicaid (IHCP)·IN · Psychiatry·Specialty Services
Effective date
Apr 1, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid provides additional clarification on ABA therapy supervision requirements, establishing that providers must maintain 1:8 supervision ratio (1 hour supervision per 8 hours of technician services) measured monthly per member starting April 1, 2026. New minimum caregiver coaching requirements of 2 hours per month or 12 hours per authorization period become effective June 1, 2026.
Action Required
By April 1, 2026: Billing team must implement monthly tracking of 1:8 supervision ratios for each Medicaid member receiving ABA therapy (CPT 97153/97154). Document all supervision activities (billable and non-billable) monthly per member. By June 1, 2026: Ensure comprehensive ABA therapy includes minimum 2 hours monthly caregiver coaching (CPT 97156/97157) or 12 hours per 6-month authorization. Claims will be subject to audit and recoupment if supervision ratios not maintained.