Behavior Analysis Services Information

Recipient Information

1. What are Behavior Analysis (BA) Services?

Behavior analysis services provide a way for a person to reduce unwanted behaviors and increase desired behaviors.  

2. Who can receive Behavior Analysis Services?

Behavior Analysis services are provided to all eligible Florida Medicaid recipients under the age of 21 years requiring medically necessary BA services. 

3. Who is eQHealth?

eQHealth Solutions is the company that will begin reviewing all requests for BA services covered under Florida Medicaid.

4. How do I find a provider?

A link to BA service providers can be found on the Agency’s Recipient Support webpage under Additional Reference Information.

5. What are the steps I take to get BA services?

Step 1: Go to your doctor and get a written order for BA services.
Step 2: Find a provider (see question 4 above)
Step 3: The BA provider will send a request for BA services to eQHealth for review.
Step 4: eQHealth has professionals that will review the information your provider submits.
Step 5: You will get a letter in the mail letting you know the outcome.

6. Who can I contact if I have more questions?

Please call the Medicaid helpline at 1-877-254-1055, if you have more questions.

*****ATTENTION BA PROVIDERS********

1.  When will eQHealth begin authorizing services for BA?

Authorizations for BA services began March 26, 2018.

2.  What documentation should be submitted to eQHealth?

Documentation requirements can be found in the Behavior Analysis coverage policy via the link provided:
http://ahca.myflorida.com/medicaid/review/Specific/59G-4.125_BA_Services_Coverage_Policy.pdf

3. Is a physician's order required to obtain an assessment, reassessment, or BA Services?

Yes, providers must submit a written physician's order to receive authorization for assessments, reassessments, and BA services in accordance with the Behavior Analysis Services Coverage Policy.

4.  Is a diagnosis code required for submission with documentation?

Yes.  Documentation must include an appropriate diagnosis code at the highest level of specificity as required by policy: http://ahca.myflorida.com/medicaid/review/Specific/59G-4.125_BA_Services_Coverage_Policy.pdf

5.  Will the Agency provide training to providers?

Yes.  The Agency and eQHealth will provide webinars periodically.  Providers will continue to be updated on impending changes through Provider Alerts.

6.  Who can I contact if I have more questions?

Please call the Medicaid helpline at 1-877-254-1055 or eQHealth at 1-855-444-3747 and via the web at http://fl.eqhs.org/.

***Behavior Analysis Provider Update***

On March 1, 2017, Applied Behavior Analysis (ABA) services ended and BA services began. Providers must be enrolled as provider type 39 with Florida Medicaid to bill for dates of service using the new BA billing procedure codes.

Starting March 26, 2018, BA service providers (provider type 39) must begin submitting prior authorization requests through eQHealth.

Questions

If you have additional (non-enrollment) questions, please contact the provider/recipient help line at 1-877-254-1055 or eQHealth at 1-855-444-3747.