ABA initial assessment report: what to include for Florida Medicaid
The 30-second answer
Under Florida Medicaid, the initial report combines the behavior assessment and the behavior plan, and it is signed by the lead analyst and the parent or guardian. It must include the Vineland-3 and, for ages 2 to 18, the BASC-3 PRQ, with their scoring reports, measurable goals with baseline and mastery criteria, caregiver training, the units requested with their medical necessity, and the supervision, care coordination, transition, crisis and discharge plans. The plan covers up to 6 months.
Key facts
What it is and who signs it
Under Florida Medicaid, the behavior assessment comes before any intervention1. Its results, together with the behavior plan, make up the report that goes with the authorization request.
The lead analyst prepares and reviews it: a BCBA, a Florida Certified Behavior Analyst (FL-CBA), or a professional licensed under Chapter 490 or 491 of the Florida Statutes. BCaBAs and RBTs work under the lead analyst’s supervision1. The report is signed by the lead analyst and by the parent or guardian1.
Before you assess: a complete referral
The referral comes from an independent physician or another qualified practitioner, and it must include two documents1:
- A physician’s order for behavior analysis services.
- A comprehensive diagnostic evaluation (CDE).
The CDE is led by a licensed practitioner and goes with the authorization request. According to AHCA, one CDE is usually enough for the treatment period unless the clinical condition changes2.
The two required instruments
Comprehensive Parent Interview Form, for everyone. From age 3, add the Maladaptive Behavior Domain.
Repeated every 12 monthsParenting Relationship Questionnaire, for ages 2 through 18.
Repeated every 12 monthsThe full scoring report for both goes with the authorization request, and you can add other tools at your discretion1. Standardized scores should not be the only basis for decisions: the CASP guidelines call for combining direct observation, interviews, record review and instruments6.
The sections of the report, one by one
Section 6.2.2 of the policy lists what the assessment and the plan must contain1. Use it as a checklist before you sign:
The plan must reflect the authorization period you request, up to 6 months1. For the assessment itself, Florida Medicaid pays up to 24 fifteen-minute units of 97151 and up to 8 of 971523.
How to write each goal
The policy asks for the same parts for every behavior or goal in the plan1. Think of these eight parts as its anatomy:
- Observable, measurable definition
- How it is observed and measured
- Baseline
- Acquisition or reduction procedure
- Conditions and mastery criteria
- Start date and estimated mastery date
- Generalization plan
- How progress is reported
The BACB Ethics Code points the same way: objectives, procedures and timelines are described in writing before implementation, and decisions rest on graphed data (items 2.16 and 2.17)5.
Parent participation
The provider must make every effort to include the parents and must document those efforts. If they cannot take part, the report explains why, how that may affect treatment, and how it will be addressed1.
Parent training by telemedicine is covered for up to 2 hours per week, and continuation requests must include data on that participation1.
Where to send the authorization
Is the child enrolled in an SMMC plan?
Authorization is required before services start and at least every 180 days after that1. Each plan may have its own form and steps, so check the child’s plan before you submit.
What is current and what may change
This guide follows the December 2024 policy (Rule 59G-4.125), effective February 10, 20251. In 2026, bill HB 5003-E created a task force at AHCA to study limits on how long ABA can be authorized. Its report is due by December 31, 2026, and no changes have been adopted so far7. Check the current version before you submit a request.
Frequently asked questions
Who reviews the authorization: my plan or Acentra?
Since February 1, 2025, most authorizations go through the child's SMMC plan. Acentra, the quality improvement organization contracted by AHCA, reviews children who are not enrolled in a plan.
How often do I have to reassess?
At least every 6 months, with an updated plan, and sooner if a new behavior emerges or more services are needed. The core instruments (Vineland-3 and BASC-3 PRQ) are repeated every 12 months.
How many 97151 units does Florida Medicaid pay?
Up to 24 fifteen-minute units per assessment. The supporting assessment (97152) has a maximum of 8 units, and the reassessment (97151-TS) a maximum of 18.
What changes at reauthorization?
Besides the updated plan, you need a progress narrative, a justification for the requested intensity, and a data table with its graph for each behavior in treatment. If progress was not clinically significant, explain why and what will change.
Sources
- Florida Medicaid Behavior Analysis Services Coverage Policy. Agency for Health Care Administration (AHCA), Dec 2024, Rule 59G-4.125, effective Feb 10, 2025.
- Behavior Analysis Services: provider information. Agency for Health Care Administration (AHCA), accessed Oct 15, 2026.
- Behavior Analysis Fee Schedule. Agency for Health Care Administration (AHCA), Oct 1, 2024.
- SMMC 3.0: Behavior Analysis Program Highlight. Agency for Health Care Administration (AHCA), Oct 18, 2024.
- Ethics Code for Behavior Analysts. Behavior Analyst Certification Board (BACB), effective Jan 1, 2022.
- Applied Behavior Analysis Practice Guidelines for the Treatment of Autism Spectrum Disorder, 3rd ed.. Council of Autism Service Providers (CASP), Apr 2024.
- ABA Task Force. Agency for Health Care Administration (AHCA), accessed Oct 15, 2026.