This form contains 69 fields organized into 19 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
ABA Assessment Code Units
97151 QHP Units Number
Enter the total number of units requested for ABA assessment code 97151 performed by a Qualified Healthcare Provider (QHP).
97152 Technician Units Number
Enter the total number of units requested for ABA assessment code 97152 performed by a technician.
Additional Code Request and Reason
Additional Code Request and Reason 1 Text
Provide details for the additional code request and the reason for it.
Assessment Request End Date
Assessment Request End Date Month Date
Enter the month for the assessment request end date.
Assessment Request End Date Day Date
Enter the day for the assessment request end date.
Assessment Request End Date Year Date
Enter the year for the assessment request end date.
Assessment Request Start Date
Assessment Request Start Date Month Date
Provide the month for the assessment request start date.
Assessment Request Start Date Day Date
Provide the day for the assessment request start date.
Assessment Request Start Date Year Date
Provide the year for the assessment request start date.
Billing Contact Information
Billing Contact Name Text
Enter the full name of the billing contact.
Billing Contact Telephone Text
Enter the telephone number for the billing contact.
Billing Contact Telephone Extension Text
Enter the telephone extension for the billing contact.
Diagnosis Codes
Primary Diagnosis Code Text
Enter the primary diagnosis code for the patient.
Secondary Diagnosis Code Text
Enter any secondary diagnosis code for the patient.
Diagnostic Practitioner Information
Diagnostic Practitioner Name Text
Provide the full name of the diagnostic practitioner.
NPI Text
Enter the National Provider Identifier (NPI) of the diagnostic practitioner.
Telephone Text
Provide the telephone number of the diagnostic practitioner.
Fax Number Text
Provide the fax number of the diagnostic practitioner.
Contact Name Text
Provide the name of the contact person for the diagnostic practitioner.
General
Rendering QHP Signature Signature
Initial Evaluation Date
Initial Evaluation Month Text
Enter the month component of the initial evaluation date.
Initial Evaluation Day Text
Enter the day component of the initial evaluation date.
Initial Evaluation Year Text
Enter the year component of the initial evaluation date.
Most Recent Evaluation Date
Most Recent Evaluation Date Month Date
Enter the month of the most recent evaluation.
Most Recent Evaluation Date Day Date
Enter the day of the most recent evaluation.
Most Recent Evaluation Date Year Date
Enter the year of the most recent evaluation.
Patient Information
Patient Name Text
Enter the full name of the patient.
Patient Date of Birth Date
Enter the patient's date of birth.
Request Submission Date Date
Enter the date this request is being submitted.
Subscriber Name Text
Enter the full name of the subscriber.
Subscriber ID Text
Enter the subscriber's identification number.
Group Number Text
Enter the group number associated with the insurance policy.
Patient Residence State Text
Enter the state where the patient resides.
Services in Same State Yes Radiobutton
Check this box if the services for the patient are conducted in the same state where the patient resides.
Services State (if different) Text
If services are not conducted in the same state as the patient's residence, enter the state where services are conducted.
PCP Type Family Practice Checkbox
Check this box if the Diagnostic Practitioner Type (PCP) is Family Practice.
PCP Diagnostic Practitioner Type
Internal Medicine Checkbox
Check this box if the PCP diagnostic practitioner's type is Internal Medicine.
Pediatrics Checkbox
Check this box if the PCP diagnostic practitioner's type is Pediatrics.
Check Box5 CheckBox
Practice Address
Practice Address Text
Enter the street address for the practice.
Practice City Text
Enter the city where the practice is located.
Practice State Text
Enter the state where the practice is located.
Practice Zip Code Text
Enter the zip code for the practice address.
Practice Contact Information
Practice Contact Name Text
Please provide the full name of the practice contact.
Practice Contact Telephone Number Text
Please provide the telephone number for the practice contact.
Practice Contact Telephone Extension Text
Please provide the telephone extension for the practice contact.
Practice Information
Practice Name Text
Provide the full legal name of the practice.
Practice NPI Text
Provide the National Provider Identifier (NPI) for the practice.
Practice Fax Number Text
Provide the fax number for the practice.
Provider Certification
Certification Date Month Date
Enter the month of the certification date.
Certification Date Day Date
Enter the day of the certification date.
Certification Date Year Date
Enter the year of the certification date.
Rendering QHP Printed Name Text
Enter the printed name of the Rendering Qualified Healthcare Provider (QHP).
Certification Practice Name Text
Enter the name of the practice for this certification.
Provider Credentials
Master's/PhD Credential or Certification Text
Please enter the Master's/PhD level clinician's state-recognized professional credential or certification.
Credential State Text
Please enter the state where the professional credential or certification was obtained.
License/Certification Number Text
Please enter the license or certification number for the clinician.
Rendering QHP Information
Rendering QHP Name Text
Enter the full name of the Rendering Qualified Healthcare Provider (QHP) who is directly providing treatment.
Rendering QHP NPI Text
Enter the National Provider Identifier (NPI) for the Rendering Qualified Healthcare Provider (QHP).
Rendering QHP Email Text
Enter the email address for the Rendering Qualified Healthcare Provider (QHP).
Rendering QHP Telephone Text
Enter the telephone number for the Rendering Qualified Healthcare Provider (QHP).
Rendering QHP Telephone Extension Text
Enter the telephone extension for the Rendering Qualified Healthcare Provider (QHP), if applicable.
Specialized ASD-Diagnosing Provider Type
Neurodevelopmental Pediatrics Checkbox
Check this box if the specialized ASD-diagnosing provider type is Neurodevelopmental Pediatrics.
Child Neurology Checkbox
Check this box if the specialized ASD-diagnosing provider type is Child Neurology.
Adult or Child Psychiatry Checkbox
Check this box if the specialized ASD-diagnosing provider type is Adult or Child Psychiatry.
Licensed Clinical Psychology Checkbox
Check this box if the specialized ASD-diagnosing provider type is Licensed Clinical Psychology.
Other (specify) Checkbox
Check this box if the specialized ASD-diagnosing provider type is not listed and specify it in the provided space.
Specialized ASD-Diagnosing Provider Type - Other Text
Please specify the specialized ASD-diagnosing provider type if it is not among the listed options.
Group1_No RadioButton