Massachusetts behavioral health billing in 2026 is shaped by three simultaneous pressures: the MassHealth ACO structure that carves BH out to Massachusetts Behavioral Health Partnership (MBHP), Massachusetts-specific commercial payer parity enforcement (BC/BS of MA, Point32Health), and Massachusetts DPH-specific SUD billing requirements different from most other states. If your MA BH, ABA, or SUD practice bills […]

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Georgia behavioral health billing in 2026 is shaped by three simultaneous pressures: Georgia Medicaid managed care rate compression across the three GA managed care organizations (Amerigroup, Peach State, CareSource), Georgia Autism Benefit-specific H0031 and H2019 modifier requirements different from most other Medicaid programs, and the Georgia DBHDD (Department of Behavioral Health and Developmental Disabilities) rate […]

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Pennsylvania behavioral health billing in 2026 is shaped by three simultaneous pressures: PA HealthChoices Medicaid managed care rate compression across the five statewide HealthChoices zones, MA HealthChoices-specific modifier documentation requirements different from most other Medicaid programs, and a MHPAEA parity opportunity on commercial denials most PA BH practices are not systematically pursuing. If your PA […]

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Ohio behavioral health billing in 2026 is being reshaped by three simultaneous pressures: the MyCare Ohio transition to Next Generation MyCare (creating dual eligible billing complexity), the Ohio Department of Medicaid (ODM) provider enrollment backlog compressing new-provider revenue, and Ohio’s specific autism benefit modifier requirements on H0031 and H2019 codes. If your Ohio BH or […]

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Florida is one of the highest-density ABA markets in the US and one of the most competitive PE-backed ABA roll-up battlegrounds. If your practice operates in Florida — whether independent, PE-backed, or founder-led — the 2026 Florida ABA billing environment demands precision that most in-house teams don’t have. Florida ABA billing hits three simultaneous pressures […]

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If your ABA practice bills Texas Medicaid, the concurrent billing rules for 97153 and 97155 have gotten more complex in 2026 — and getting the modifier stack wrong is now the single most common cause of denied concurrent claims across Texas ABA practices we work with. Texas Medicaid requires U-series modifiers (U1, U2, U3, and […]

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