Translating Medical Necessity Criteria (MNC) for ABA Providers Working with Health Plans becomes clinically important the moment a team has to turn good intentions into reliable action inside clinic sessions and day-to-day service delivery. For this course, the practical stakes show up in service continuity, accurate reporting, and defensible clinical decisions, not in abstract discussion alone.
Provider: BehaviorLive — via Jade Health
Take This Course →Including ethics, supervision, and topics like this one. New live CEU every Wednesday.
Join Free →Many health care contracts include agreements which state that a plan will provide coverage only for services that are deemed reasonable and necessary, which is up to the discretion of health plans. This is the deciding factor known as Medical Necessity Criteria (MNC). Join us as we discuss the current best practices for determining medical necessity in autism/ABA treatment!
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 1 | General |
| QABA | 1 | General |
| IBAO | 1 | — |
| BICC | 0 | — |
Dr. Diana Davis-Wilson, DBH, LBA, BCBA, IBA is an Arizona Licensed Behavior Analyst with extensive experience in providing consultation and training to families, school districts, and organizational personnel across the nation. For several years, Dr. Davis-Wilson held a leadership position at an autism provider organization based in Arizona. In this role, she oversaw applied behavior analysis programs for numerous children throughout the state. Driven by her commitment to professional development and sustainability within the field of behavior analysis, she created an inclusive curriculum-based supervision program that provided employment opportunities and training for aspiring professionals and students. In addition to her clinical leadership roles, Dr. Davis-Wilson has actively contributed to various boards both in Arizona and on a national level. Her positions have included AzABA (Association for Behavior Analysis), the Autism Advisory Council of the Arizona Health Care Cost Containment System (AHCCCS), Glendale Community College's Behavioral Health Sciences Occupational Advisory Board (BHS-OAB), the Behavioral Health Centers of Excellence Scientific Advisory Board (BHCOE), and the Development Disabilities Safety Council. Furthermore, she has been appointed by the Governor as a board member with the Arizona Board of Psychologist Examiners. Dr. Diana Davis-Wilson is also a university professor. She actively collaborates with other professional organizations to provide education, advocacy efforts, and guidance on early access to care, best practices, and evidence-based treatment methods. Additionally, she is deeply passionate about offering law enforcement training regarding autism developmental disabilities, crisis response, and behavior analysis.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
279 research articles with practitioner takeaways
258 research articles with practitioner takeaways
All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.