Applied Behavioral Analysis Therapy Diagnostic Requirements

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TO: Pediatric Physicians & Certified Registered Nurse Practitioners (CRNP)

RE: Applied Behavioral Analysis Therapy Diagnostic Requirements

Effective July 1, 2026, the Alabama Medicaid Agency (Medicaid) requires physicians enrolled as Provider Type 31 with Specialty 345 (Pediatricians) to submit a written request on official letterhead if they wish to add Applied Behavioral Analyst (ABA Specialty 175) to their enrollment. This specialty designation will be required for the autism diagnosis to be valid for ABA Therapy referrals.

The request must include the following information:

• Provider Name
• National Provider Identifier (NPI)
• Alabama Medicaid Provider Number
• Service Location Address

There is no retroactive date for the addition of the ABA Specialty 175. The effective date will be the date when the specialty is approved and added to the provider's enrollment file. Referrals for ABA Therapy based on an autism-related diagnosis will be denied if it is submitted by a pediatrician who does not have the ABA Specialty designation.

Certified Registered Nurse Practitioners (CRNPs) are not authorized to make a diagnosis of autism-related conditions for referrals to ABA Therapy for Medicaid beneficiaries.

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