The amendment adds "25. Applied Behavioral Analysis (ABA) Therapy" under EPSDT in Attachments 3.1-A and 3.1-B, with services "provided in accordance with 42 CFR 440.130(c)" and the footer "TN: AR-24-0015 Approval: 11-07-2024 Effective Date: 01-01-2025" (CMS-hosted SPA AR-24-0015). One page of the amendment prints an approval date of 11/07/25, which appears to be a typo, since every other page prints 11/07/2024. The provider manual and the fee schedule are hosted on humanservices.arkansas.gov, which failed the secure connection on every attempt.
Search results reported the ABA provider manual as effective January 1, 2025 and quoted rate figures from a fee schedule PDF, but the manual and that PDF could not be retrieved, so nothing from them is repeated here. Confirm place of service, prior authorization, PASSE and Autism Waiver handling, and rates with the Department of Human Services.
The reimbursement criteria at a glance
- Is ABA covered by Arkansas Medicaid
- Who is eligible: EPSDT and the primary care prescription
- Who may provide ABA
- How Arkansas pays: the method, not the rates
- Practices with in-house diagnostics versus ABA-only practices
- How this connects to the rest of your compliance stack
- Getting set up to bill Arkansas Medicaid: the sequence
- What this guide could not verify
- Arkansas reimbursement variables at a glance
- Frequently asked questions
- Where professional advice is essential
Is ABA covered by Arkansas Medicaid
Yes. The state plan reads that "Applied Behavior Analysis (ABA) therapy is only one component of services to treat Autism Spectrum Disorder (ASD). ABA therapy services are provided in accordance with 42 CFR 440.130(c)." The covered components are behavior identification assessment services (comprehensive evaluations and the initial individualized treatment plan), ABA therapy treatment services delivered to the beneficiary under that plan, adaptive behavior treatment with protocol modification, and family adaptive behavior treatment services, which are meetings between the caregiver and "the supervising BCBA" (SPA AR-24-0015, Attachments 3.1-A and 3.1-B, item 4b.25).
Who is eligible: EPSDT and the primary care prescription
The benefit sits under "Early and Periodic Screening and Diagnosis of Individuals Under 21 Years of Age, and Treatment of Conditions Found," and the plan states that "ABA therapy services must be prescribed by the beneficiary's Arkansas Medicaid assigned primary care provider (PCP)" (SPA AR-24-0015). The prescription form and the process for beneficiaries in managed care or the Autism Waiver were not retrieved.
Who may provide ABA
"ABA therapy services must be performed by a" board-certified behavior analyst "who must have board-certified behavior analyst (or more advanced) certification in good-standing from the Behavior Analyst Certification Board," a board-certified assistant behavior analyst with BACB certification in good standing, or a registered behavior technician with BACB certification in good standing (SPA AR-24-0015). Medicaid enrollment steps, background check rules, and group-practice billing rules from the provider manual were seen only in a secondary source and are not stated here.
How Arkansas pays: the method, not the rates
The state plan states that "Applied Behavior Analysis (ABA) therapy services are reimbursed on a per unit basis using fee schedule reimbursement methodology, where reimbursement is made at the lower of the billed charge for the service or the maximum allowable reimbursement for the service under Arkansas Medicaid." The department "engaged an independent actuary to conduct a rate study on ABA therapy services during the summer of 2023 to determine appropriate service rates," and "the applicable fee schedule of ABA therapy service rates is published on the agency's website" (SPA AR-24-0015, Attachment 4.19-B, item 19a). The fee schedule itself could not be read, so no per-unit rate for any code is stated.
Practices with in-house diagnostics versus ABA-only practices
The prescription must come from the beneficiary's assigned primary care provider, so neither a practice with a psychologist on staff nor an ABA-only practice can originate the order itself. The in-house diagnostic fork matters for the evaluation and the treatment plan, which the behavior analyst develops, and it depends on managed care and waiver rules this guide could not read.
How this connects to the rest of your compliance stack
The credential the plan relies on is BACB certification. The state's own registration for behavior analysts is covered on the Arkansas Licensing page, and the entity analysis is on the Arkansas entity page.
Getting set up to bill Arkansas Medicaid: the sequence
- Hold current BACB certification. BCBA or higher, BCaBA, or RBT, in good standing.
- Confirm enrollment mechanics with the department. The provider manual could not be read.
- Obtain the PCP prescription. It must come from the beneficiary's assigned primary care provider.
- Work from the published fee schedule. The plan says the schedule is published on the agency's website.
What this guide could not verify
- Per-unit rates for 97151 to 97158. The fee schedule PDF failed the secure connection, and search-result figures are not repeated.
- Place of service, school, and telehealth rules for ABA.
- Prior authorization process and reviewer, hour limits, and handling for PASSE managed care and Autism Waiver enrollees. The prescription and referral form also failed to load.
- Medicaid enrollment steps, background check rules, and group-practice billing rules from the provider manual.
- The commercial autism mandate in the Arkansas Code, its age cap, and its dollar cap. Only secondary sources surfaced, so none is quoted.
Arkansas reimbursement variables at a glance
| Variable | Arkansas value |
|---|---|
| ABA covered by Medicaid? | Yes, as an EPSDT state plan service (SPA AR-24-0015, effective January 1, 2025) |
| Age | Under 21 |
| Prescriber | Beneficiary's assigned Arkansas Medicaid primary care provider |
| Providers | BCBA (or more advanced), BCaBA, RBT, each in good standing with the BACB |
| Payment method | Per-unit fee schedule; lower of billed charge or maximum allowable; based on a 2023 rate study |
| Rates | Not verified |
| Place of service and prior authorization | Not verified |
| Commercial mandate | Not verified |
Frequently asked questions
When did Arkansas start covering ABA under Medicaid?
Who must prescribe ABA?
Can an RBT perform services?
What does Arkansas pay per unit?
Where professional advice is essential, not optional
Arkansas's state plan is clear on who prescribes and who may perform ABA, and silent in the pages this guide could read on the details that drive revenue. Bring in a billing specialist to work from the department's fee schedule and provider manual.
The governing authority to know is State Plan Amendment AR-24-0015.
This page describes rules read from the CMS-hosted state plan amendment. The Department of Human Services' provider manual and fee schedule could not be read. The department, the state insurance regulator, and each payor provide current requirements. Do not rely on this page or any secondary source in place of direct verification.