Montana Medicaid Gives ABA 1,260 Units Per 180 Days. Unused Units Expire.

Montana Medicaid's ABA Services Manual authorizes treatment in blocks. The initial 180 calendar days carry a package of 1,260 total units, and the manual says "unused units of service will be considered expired once the initial 180 calendar days have elapsed." A unit is 15 minutes, so the package is 315 hours.

The arithmetic that decides your schedule

Spread evenly over 180 days (about 25.7 weeks), 1,260 units works out to roughly 49 units, or 12.25 hours, a week. Most plans run heavier than that, and the manual accounts for it: review "will occur every 180 calendar days or when the initial or subsequent authorized units of service are exhausted."

• At 20 hours a week (80 units), the package is gone in about 15.75 weeks, around day 110.
• At 25 hours a week (100 units), it is gone in 12.6 weeks, around day 88.
• At 12 hours a week or less, you reach day 180 with units to spare, and the spare units expire.

The 14-day lead time

For continued services, the BCBA "must submit the form and additional documentation at least 14 calendar days prior to the intended onset of continued service delivery." Initial authorization starts with the Intent to Initiate Treatment form, which the manual says "must be completed and submitted by the BCBA." All services are billed under the BCBA's NPI. A Telehealth Exception Request form exists for telehealth delivery.

Who it covers

Montana Medicaid covers ABA for members with autism through age 20; members with a serious emotional disturbance through age 17, or through 20 if enrolled in an accredited secondary school and meeting functional-impairment criteria; and members eligible for state developmental disabilities services through age 20.

What isn't established here

The manual language we read describes the initial package. We could not confirm from the page how many units a later block carries, so check the current manual and your authorization letter before assuming the same 1,260 repeats.

What to do this week

• Owners and clinical directors: for each Montana Medicaid client, multiply scheduled weekly hours by four to get units per week, then divide 1,260 by that number. That is the week your units run out. Work backward 14 days from it to set the filing date.
• BCBAs: if a client is scheduled below about 12 hours a week, look at whether the gap is clinical or just cancellations. Units left on day 180 are gone.
• Billers: confirm every claim carries the BCBA's NPI, not the RBT's.