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New provider and new payer readiness checklist

A new BCBA or RBT can be ready clinically weeks before they are ready to bill. Use this payer by payer before their first billable session, and again whenever you add a new payer.

Checked November 2, 2026 · Billing4ABA · Billing built only for ABA.

Fill one copy per new provider. For each payer, every line needs a yes before the first billable session.

License and certification

  • BCBA: BACB certification current.
  • Texas: TDLR license active (LBA or LaBA), with the expiry date on the calendar.Texas licensing for behavior analysts began in 2018 under Occupations Code ch. 506.
  • RBT, BCAT or ABAT: certification current and a supervising behavior analyst named.

Identity and profile

  • Type 1 NPI issued, with the taxonomy matching your EHR and payer files.
  • RBTs: each payer asked whether they need an individual NPI.
  • CAQH profile complete, attested, and your clinic authorized to view it.

Enrollment, payer by payer

  • Linked to the group contract, or enrolled separately, as each payer requires.
  • Status logged in the credentialing tracker, with an owner and a follow-up date.
  • Effective date received in writing, for each payer.
  • Payer's provider ID recorded.
  • Each payer's rule for technicians written down: credentialed, or billed under the supervisor.

Texas Medicaid note

  • A new LBA completes their own TMHP enrollment through PEMS, then credentialing with each managed care plan you serve.
  • The LBA's individual NPI is both the rendering and the billing provider; groups do not enroll.
  • LaBAs and technicians do not enroll; they work under LBA supervision.
  • The LBA's TDLR license does not expire within 30 days of applying.

EHR setup

  • Provider profile created with NPI, credential and taxonomy.
  • Codes they can render, and the modifiers each payer expects for their level.
  • Supervisor linked to each technician.
  • Scheduling blocks billable sessions for payers where they are not yet effective.

Supervision structure

  • Supervising BCBA or LBA assigned for each technician and each case.
  • Supervision schedule meets BACB and each payer's requirements.
  • Supervision is documented where an auditor would look for it.

Authorization and provider match

  • Each authorization lists the right provider, where the payer names one.
  • If a new BCBA takes over a case, the payer asked whether the authorization must be updated.

Adding a new payer

  • Contract signed, effective date in writing, fee schedule loaded.
  • Payer ID added in the clearinghouse; claims, ERA and EFT enrollment done.
  • Authorization rules and filing limit written down from the plan's manual.
  • One test claim sent and checked before the full schedule bills.

Sources

  1. [1]TMHP: Licensed behavior analyst enrollment (PDF)
  2. [2]1 TAC §354.5011
  3. [3]TDLR: Behavior analysts at a glance (PDF)
  4. [4]CASP / txABA webinar on Texas Medicaid ABA (2022). Check each plan's current instructions.

Checked November 2, 2026. Payer rules change; confirm with the payer and the cited source before acting.

Billing4ABA is a billing service, not legal counsel. Payer rules change; confirm with the payer before acting.

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