July 20, 2015
CSHCS is now able to accept and process Prior Authorization (PA) for ABA T-codes.
The acceptable T-codes are 0364T and 0365T or 0368T and 0369T. CSHCS will write PAs for these codes if the participant has primary insurance coverage that requires the billing of T-codes. Please remember that our policy still does not
allow paraprofessionals to give ABA therapy to our participants. CSHCS must know the number of hours per week that the BCBA or BCaBA directly supervised by the BCBA on site will provide ABA therapy.
If an ABA provider has a PA in place for 2015 with 97532 or 96152 for a participant, please understand that the Claims section cannot pay for the same dates of service for T-codes and 97532 or 96152.
The maximum benefit for each participant remains $10,000 per calendar year.
If you have any questions regarding these changes, please contact the Prior Authorization Unit at 1-800-475-1355, Option 3.
To print this for your records: T-Code Communication Letter
June 29, 2015
Effective July 1, 2015, the mileage reimbursement rate will change to $.20 per mile for family travel.
April 30, 2015
We now have a list of Frequently Asked Questions (FAQs) available here
January 26, 2015
The 2015 Household Income Guidelines are now available through the Participant Eligibility page.
December 8, 2014
The Children’s Special Health Care Services (CSHCS) Program has developed a Request for Authorization
form for providers. The use of this form is required when submitting requests for prior authorization. You may print and make copies as necessary. Please complete and submit this form each time you request a prior authorization, along with any other necessary documentation. This form will help to streamline the authorization process and allow us to make a determination more quickly and efficiently.