Alabama Medicaid adds new prior referral requirement for ABA therapy starting July 1

Alabama Medicaid will require a prior referral for all Applied Behavior Analysis therapy claims related to autism spectrum disorder, effective July 1, 2026. The new rule mandates that a primary care physician or specialist must issue the referral before ABA services can be billed. Claims submitted without the documented referral after the go-live date will be denied. Providers must update their intake workflows for pediatric patients and verify the referral is in the patient's chart before initiating ABA services. Contact the Alabama Medicaid provider portal for the specific referral form and documentation requirements.