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DMAS forms are official documents issued by the Virginia Department of Medical Assistance Services, the state agency that administers Medicaid and other publicly funded health programs. These forms play a central role in the authorization, planning, and delivery of healthcare services for Medicaid members — particularly those receiving behavioral health and developmental services. Whether it's requesting prior approval for a specific treatment or establishing a structured care plan, each form serves a defined purpose in ensuring that services meet medical necessity standards and align with state and federal Medicaid requirements.
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About DMAS forms
These forms are typically completed by licensed healthcare providers, behavioral health clinicians, case managers, and administrative staff on behalf of Medicaid members. For example, the ABA Preservice Service Authorization Request Form is used by providers seeking approval for Applied Behavior Analysis therapy before services begin, while the Enhanced Services Individual Service Plan Template helps mental health providers document individualized treatment goals and coordinate ongoing care. Getting these forms right matters — errors or omissions can delay authorizations and disrupt care for vulnerable individuals.
Because many DMAS forms are detailed, multi-section documents that require precise clinical and administrative information, completing them accurately can be time-consuming. Tools like Instafill.ai use AI to fill these forms in under 30 seconds, handling the data accurately and securely — a practical time-saver for busy providers managing high caseloads.
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How to Choose the Right Form
These two DMAS forms serve different stages of the behavioral health service process. Use the descriptions below to quickly identify which one applies to your situation.
Requesting Authorization for ABA Services
If you are a provider seeking prior approval to deliver Applied Behavior Analysis (ABA) therapy, you need the ABA Preservice Service Authorization Request Form (Effective 09/01/2025 and after). This form is specifically for:
- Requesting preservice (prior) authorization for ABA CPT codes 97153–97158 and 0373T
- Documenting member diagnoses, requested service hours/units, and admission criteria
- Capturing preliminary treatment goals before services begin
- Noting telemedicine delivery when applicable
- Retroactive review situations where indicated
This form is submitted to DMAS or the member's health plan so that medical necessity can be evaluated before services are rendered.
Creating an Individualized Treatment Plan for Enhanced Behavioral Health Services
If you are a licensed mental health provider building a structured, person-centered treatment plan for a Medicaid member enrolled in enhanced behavioral health services, use the Enhanced Services Individual Service Plan (ISP) Template. This form is the right choice when you need to:
- Document measurable treatment goals, objectives, and interventions
- Record care coordination activities across multiple providers
- Outline a recovery and discharge plan
- Meet Medicaid authorization requirements for enhanced services
- Ensure continuity and accountability throughout the member's care
Quick Decision Summary
| Need | Use This Form |
|---|---|
| Prior auth for ABA therapy (CPT 97153–97158, 0373T) | ABA Preservice Service Authorization Request |
| Individualized treatment plan for enhanced behavioral health | Enhanced Services ISP Template |
Both forms can be completed online using Instafill.ai's AI-powered tools, saving time and reducing errors on these complex, multi-page documents.
Form Comparison
| Form | Purpose | Who Files It | When to Use |
|---|---|---|---|
| The Department of Medical Assistance Services Applied Behavior Analysis Preservice Service Authorization Request Form (Effective Dates of Service 09/01/2025 and after) | Request prior authorization for ABA therapy services | ABA providers billing CPT codes 97153–97158, 0373T | Before delivering ABA services or for retro review |
| Department of Medical Assistance Services Enhanced Services Individual Service Plan (ISP) Template | Create individualized treatment plans for behavioral health members | Licensed mental health providers serving Medicaid members | When enrolling members in enhanced behavioral health services |
Tips for DMAS forms
Before starting any DMAS form, collect the member's Medicaid ID, date of birth, diagnosis codes, and the provider's NPI and license number. Having these details on hand prevents mid-form interruptions and reduces the risk of errors that could delay authorization.
For ABA preservice authorization requests, ensure the CPT codes you list (97153–97158, 0373T) match exactly the services being requested. Mismatched codes or inaccurate unit counts are a leading cause of authorization denials or requests for additional information.
Both the ABA authorization form and the ISP template require treatment goals that directly support documented medical necessity. Make sure each goal and objective is measurable, time-bound, and clearly tied to the member's diagnosis and functional limitations to strengthen your authorization request.
AI-powered tools like Instafill.ai can complete complex DMAS forms — including multi-page ISP templates and ABA authorization requests — in under 30 seconds with high accuracy. Your data stays secure throughout the process, making it a practical time-saver when managing multiple members or tight submission windows.
If any ABA services are delivered via telemedicine, the preservice authorization form requires this to be noted specifically. Omitting telemedicine documentation can result in claim denials after services are rendered, so flag this clearly during the authorization stage.
The DMAS Enhanced Services ISP template is designed around recovery-oriented, person-centered planning. Avoid vague language like 'will improve coping skills' — instead, write objectives with observable behaviors, measurable benchmarks, and realistic timeframes to satisfy Medicaid reviewers and support genuine care continuity.
Maintain a organized digital record of all submitted DMAS forms, including submission dates and authorization numbers received. This documentation is essential for audits, retro reviews, and coordinating care across multiple providers involved in a member's treatment.
DMAS forms are periodically updated, and using an outdated version can result in rejection. Always confirm you are using the form version that matches the intended dates of service — for example, the ABA form specifies an effective date of 09/01/2025 and after.
Frequently Asked Questions
DMAS (Department of Medical Assistance Services) forms are official Virginia Medicaid documents used to request, authorize, and document healthcare services for eligible members. They are required by providers and members to obtain prior authorization, create treatment plans, and ensure services meet medical necessity criteria before Medicaid reimbursement is approved.
If you are a provider seeking prior authorization for Applied Behavior Analysis (ABA) therapy services under specific CPT codes, you need the ABA Preservice Service Authorization Request Form. If you are a licensed mental health provider creating a structured, individualized treatment plan for a member enrolled in enhanced behavioral health services, you need the Enhanced Services Individual Service Plan (ISP) Template.
This form is typically completed by ABA providers or their clinical staff on behalf of a Medicaid member who requires Applied Behavior Analysis services. It must be submitted to DMAS or the relevant health plan before services begin in order to obtain prior authorization and confirm medical necessity.
An Individual Service Plan (ISP) is a structured, person-centered treatment plan that outlines a member's goals, interventions, and path toward recovery. Licensed mental health providers working with Virginia Medicaid members enrolled in enhanced behavioral health services are responsible for completing and maintaining this document as a condition of Medicaid authorization.
Preservice authorization requests should generally be submitted before the delivery of services, as DMAS and health plans use them to approve the type, amount, and duration of care in advance. In some cases, retroactive review may be permitted, but submitting prior to service delivery is the standard expectation to avoid claim denials.
Completed DMAS forms are typically submitted to the Department of Medical Assistance Services directly or to the member's managed care health plan, depending on how the member's Medicaid coverage is administered. Providers should verify the specific submission method — whether electronic, fax, or portal — with DMAS or the relevant health plan before sending.
DMAS forms generally require member demographic and Medicaid ID information, provider details and credentials, diagnosis codes, requested service types and hours, and documentation supporting medical necessity. Treatment goal forms like the ISP also require measurable objectives, planned interventions, and a recovery or discharge plan.
Yes, many DMAS forms — particularly service plans like the ISP — require periodic updates to reflect a member's progress, changing needs, or updated treatment goals. Authorization request forms may also need to be resubmitted when existing authorizations expire or when additional services are needed beyond what was originally approved.
Yes, AI-powered tools like Instafill.ai can fill out DMAS forms in under 30 seconds by accurately extracting and placing data from source documents such as clinical records or prior authorizations. This is especially helpful for complex, multi-page forms like the Enhanced Services ISP Template, where Instafill.ai can also convert non-fillable PDF versions into interactive fillable forms.
Manually completing DMAS forms can take significant time, especially for detailed documents like the ISP Template that require clinical narratives, goals, and intervention plans. Using an AI tool like Instafill.ai, these forms can be completed in under 30 seconds by automatically populating fields from existing documentation, greatly reducing administrative burden for providers.
Yes, DMAS forms are issued by Virginia's Department of Medical Assistance Services and are specific to Virginia's Medicaid program. Providers and members outside of Virginia would need to use the equivalent forms from their own state's Medicaid agency.
If a DMAS preservice authorization request is denied, providers and members typically have the right to appeal the decision through DMAS or the relevant managed care health plan. The denial notice will generally include the reason for denial and information about the appeals process and applicable deadlines.
Glossary
- DMAS
- The Department of Medical Assistance Services, Virginia's state agency that administers the Medicaid and CHIP programs, overseeing healthcare coverage and benefits for eligible low-income residents.
- Service Authorization (Prior Authorization)
- A required approval from DMAS or a managed care health plan that must be obtained before certain services are delivered, confirming that the treatment meets medical necessity criteria and will be covered by Medicaid.
- Applied Behavior Analysis (ABA)
- A therapeutic approach based on behavioral science, commonly used to improve social, communication, and adaptive skills—particularly for individuals with autism spectrum disorder—and billed under specific CPT codes such as 97153–97158 and 0373T.
- CPT Codes
- Current Procedural Terminology codes are standardized numeric codes used to identify and bill specific medical, surgical, or behavioral health services; DMAS uses these codes to determine which services require authorization.
- Individual Service Plan (ISP)
- A personalized, written treatment plan developed by a licensed provider that outlines a Medicaid member's behavioral health goals, measurable objectives, interventions, and a path toward recovery or discharge.
- Medical Necessity
- A standard used by DMAS and health plans to determine whether a requested service is clinically appropriate, evidence-based, and required to diagnose or treat a member's condition before approving coverage.
- Enhanced Services
- A category of intensive, structured behavioral health services covered by Virginia Medicaid for members with significant mental health needs, requiring detailed documentation such as an ISP for authorization.
- Person-Centered Planning
- A care planning approach that places the individual's preferences, strengths, and goals at the center of their treatment plan, required by DMAS to ensure services are tailored to each member's unique needs.
- Telemedicine
- The delivery of healthcare services remotely via video or other technology; DMAS requires providers to document when ABA or other services are provided via telemedicine on authorization request forms.
- Retro Review
- A retrospective authorization review conducted after services have already been delivered, used in specific situations where prior authorization was not obtained in advance but Medicaid coverage is still being sought.