Service InformationWhat is Behavior Analysis
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Updates and Resources
Behavior analysis services provide a way for a person to reduce unwanted behaviors and increase desired behaviors. More information, including fact sheets and videos, is located on the Behavior Analyst Certification Board’s website.
The Agency has hosted several public meetings to introduce proposed updates to Medicaid-covered behavior analysis services. These updates are intended to ensure children receive the right service, at the right time, and by the right provider. It is of chief importance to the Agency that children who need behavior analysis services receive the highest quality of care and continue to receive services in a timely manner. Here is a summary of the updates:
|Behavior Analysis Rates||
|Health Care Clinic Licensure||
|Multidisciplinary Team (MDT)||
|Electronic Visit Verification||
|Behavior Analysis Coverage Policy||
|Topic||Date and Time||Link|
|eQHealth Solutions' Multidisciplinary Trainings||Recurring||Register for these trainings on eQHealth Solutions' website: http://fl.eqhs.org/ProviderResources/Registerforawebinar.aspx|
|Tellus Electronic Visit Verification Trainings||Recurring||Register for these trainings on Tellus’ website, under the Training & Resources tab: https://4tellus.com/ahca-ba/|
|Behavior Analysis Provider Enrollment (May 2019)||Presentation: Enrolling as a Florida Medicaid Behavior Analysis Provider
Webinar Recording: Enrolling as a Florida Medicaid Behavior Analysis Provider
|Behavior Analysis Provider Enrollment (April 2019)||Medicaid Behavior Analysis (Provider Type 39) Enrollment Webinar|
|Behavior Analysis Updates (April 2019)||Presentation: Florida Medicaid Behavior Analysis Updates 2019
Webinar Recording: lorida Medicaid Behavior Analysis Updates 2019
|Health Care Clinic Licensure||Frequently Asked Questions|
|Electronic Visit Verification||Presentation: Florida Medicaid Behavior Analysis Updates 2019
Webinar Recording: Florida Medicaid Behavior Analysis Updates 2019
Electronic Visit Verification Frequently Asked Questions
eQHealth Solutions now makes all new determinations for Behavior Analysis (BA) services. This is the company that decides if your child needs BA services. When a decision is made, eQHealth will send you a letter. The following questions provide additional 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.
7. Who can I contact if I am having issues with receiving BA services?
Please contact the Medicaid helpline at 1-877-254-1055 to report those issues.
8. What is a prior authorization number?
A prior authorization number is a number that is 10 digits long, has no hyphens, and begins with “5.”
To obtain approval for Behavior Analysis services, providers must submit all new authorization requests to eQHealth Solutions, the Agency’s contracted Quality Improvement Organization for this service. For further information, please reference the following FAQs:
1. What documentation should be submitted to eQHealth?
When submitting prior authorization requests to eQHealth, BA providers will need to submit documentation that meets the requirements in section 9.0 of the Behavior Analysis Services Coverage Policy.
2. 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.
3. 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
4. Where can I access training documents and information about eQHealth’s BA implementation?
5. 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://eqhs.org/.
To obtain approval for Behavior Analysis services, providers must submit all new authorization requests to eQHealth Solutions, the Agency’s contracted Quality Improvement Organization for this service. For further information, please reference the following:
To learn more about the provider enrollment process for behavior analysis services, please review the presentation materials on the Agency’s website. For additional assistance, please contact a customer service representative at 1-800-289-7799, Option 4.Additional information is available on the Agency’s website: