Applied Behavior Analysis (ABA) provider enrollment alert

Washington State Health Care Authority sent this bulletin at 06/26/2025 08:00 AM PDT

June 26, 2025

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Reminder: Applied behavior analysis (ABA) provider enrollment

This is a reminder that effective June 30, 2025, all certified behavior technicians (CBT) and licensed assistant behavior analysts (LABA) working with Apple Health (Medicaid) clients must be enrolled with Apple Health.

Notification of this requirement was first issued in a June 2023 provider alert detailing which individual providers must be enrolled with Apple Health and identified as servicing providers on ABA claims. HCA will continue to work with the Department of Health (DOH) and the managed care organizations (MCOs) to ensure the process is as efficient as possible.

Providers who render services to Apple Health clients must be enrolled with the Health Care Authority (HCA) under the billing providers’ Core Provider Agreement (CPA). See WAC 182-502-0005(2) for more information.

All ABA providers, including CBTs and LABAs, must be enrolled with Apple Health as a servicing provider, also known as rendering or performing provider. Their National Provider Identifier (NPI) must be listed on claims for services provided.

Requirements for CBTs and LABAs working with Apple Health clients

Effective June 30, 2025 CBTs and LABAs must:

Have an active CBT or LABA license with the Department of Health (DOH).
Have an NPI.
If part of a health care group or organization with a CPA, enroll with HCA as a servicing provider or nonbilling provider under the group’s CPA.
If applicable, be listed as a servicing provider on the group’s roster submitted to the managed care organization (MCO).
For dates of service on and after July 1, 2025, have their NPI captured on the claim as the servicing provider for services rendered.

Additional information

WAC 182-502-0002 for eligible provider types.
WAC 182-531A-0800 for ABA provider requirements.
Applied Behavior Analysis (ABA) Program Billing Guide.
HCA’s Provider Enrollment webpage.
HCA's ABA Technical Assistance call slide deck from February 27, 2025.

ABA mailing list

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Contact

Email: Applied Behavior Analysis

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.