Medi-Cal Enrollment Requirements for Applied Behavioral Analysis (ABA) Groups
| Date: | April 29, 2026 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan ABA Groups |
| Type: | Regulatory |
| Subject: | Medi-Cal Enrollment Requirements for Applied Behavioral Analysis (ABA) Groups |
| Business: | Medi-Cal Managed Care |
Medi-Cal Enrollment Requirements for Applied Behavioral Analysis (ABA) Groups As a follow-up to the Provider Alert, in accordance with Department of Health Care Services (DHCS) All Plan Letter (APL) 22-013, Applied Behavioral Analysis (ABA) groups in Health Plan’s network must also enroll in the Medi-Cal program.
ABA Groups
ABA groups who provide services to Medi-Cal members must be Medi-Cal enrolled to receive reimbursement by Health Plan. This requirement is already in effect; however, Health Plan will allow a grace period for ABA groups to complete their Medi-Cal enrollment.
- Any ABA group who does not demonstrate efforts to get Medi-Cal enrolled within six (6) months of this alert are at risk of termination.
- Any ABA group who has not completed their Medi-Cal enrollment at the time of re-credentialing are at risk of termination.
ABA groups can enroll in Medi-Cal through DHCS PAVE Portal found here: https://pave.dhcs.ca.gov/sso/login.do. Additional details can be found on the DHCS website.
Please note: Licensed ABA providers who practice individually and not as part of a group contract must be Medi-Cal enrolled.
For more information on APL 22-013, please visit https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2022/APL22-013.pdf.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
