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It defines “practice of applied behavior analysis,” emphasizing design, implementation, and evaluation of environmental modifications using functional assessment and measurement. 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.........................................................................................................3  \nDefinitions ...................................................................................................................................3  \nNetwork Provider Eligibility ...........................................................................................................4  \nProvider Requirements .................................................................................................................5  \nLicensure Requirements ...........................................................................................................5  \nProgram Components ..................................................................................................................5  \nOverview of Treatment Phases ..................................................................................................5  \nDiagnosis/Evaluation ............................................................................................................5  \nInitial Pre-certification ..........................................................................................................6  \nDischarge Planning ...............................................................................................................8  \nNot Medically Necessary/Exclusions ............................................................................................8  \nTelehealth ............................................................................................................................8  \nAdditional Non-Covered Services ..........................................................................................9  \nEssential Practice Elements of ABA ..............................................................................................9  \nTreatment Modalities: ................................................................................................................ 10  \nGroup adaptive behavior treatment by protocol*:.................................................................10  \nFamily adaptive behavior treatment guidance: .....................................................................10  \nMultiple-family group adaptive behavior treatment guidance: ..............................................11  \nProvider Program Requirements and Expectations ......................................................................11  \nMonitoring of Quality .................................................................................................................. 12  \nAnnual Quality Review ........................................................................................................ 13  \nCoding....................................................................................................................................... 13  \nReferences and Resources ......................................................................................................... 13  \nDSM-5-TR Criteria for Autism Spectrum Disorder Diagnostic criteria:....................................13  \nAssessment Tools:.............................................................................................................. 15  \nAdditional Resources .......................................................................................................... 15  \nWebsites for Additional Information .................................................................................... 15  \nABA Codes ......................................................................................................................... 15  \nOverview of the ABA Benefit  \nThe Division of TennCare along with the contracted Managed Care Organizations (MCO), BlueCare, United Healthcare, and Wellpoi","cbCaiqNtiiqTDn0O","https://ap.wps.com/l/cbCaiqNtiiqTDn0O","pdf",482995,16,"English","# Overview of the ABA Benefit\n## Definitions\n# Network Provider Eligibility\n# Provider Requirements\n## Licensure Requirements\n## Program Components\n## Overview of Treatment Phases\n## Diagnosis/Evaluation\n## Initial Pre-certification\n## Discharge Planning\n## Not Medically Necessary/Exclusions\n## Telehealth\n## Additional Non-Covered Services\n# Essential Practice Elements of ABA\n## Treatment Modalities\n## Provider Program Requirements and Expectations\n# Monitoring of Quality\n## Annual Quality Review\n# Coding\n# References and Resources","[{\"question\":\"What does TennCare require ABA network providers to attest to?\",\"answer\":\"Providers must attest to offering treatment as specified in the program description for members who meet medical necessity criteria for ABA services.\"},{\"question\":\"How does the document define the practice of applied behavior analysis?\",\"answer\":\"It defines ABA as the design, implementation, and evaluation of environmental modifications by a behavior analyst, including functional assessment and identification of functional relations between behavior and environmental factors.\"},{\"question\":\"Which activities are explicitly excluded from ABA treatment modalities?\",\"answer\":\"The program expressly excludes psychological testing, neuropsychology, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, and long-term counseling as treatment modalities.\"}]","ABA Provider Requirements and Program Description - TennCare Managed Care Organizations | PDF",1789912778]