Children's Developmental Disability Agencies

Effective December 1, 2025, BMC services will no longer be managed by Magellan Healthcare. Providers may continue to send prior authorization requests for BMC services to Magellan Healthcare through November 30, 2025. Providers in the process of a new plan or amendment for their members may choose to submit to Telligen now instead of Magellan to then be transferred over to Telligen. 

Idaho Medicaid, Magellan Healthcare, and Telligen are working together to transfer all approved BMC authorizations extending beyond November 30, 2025, from Magellan Healthcare to Telligen. Any authorization expiring in less than 90 days will be extended to ensure at least 90 days of coverage.

• All active authorizations with Magellan Healthcare for BMC will cease November 30, 2025.
• Telligen will issue new BI authorizations, and all current authorizations will be extended by at least 90 days.
• Authorizations expiring between December 1, 2025, and March 1, 2026, will be extended to March 1, 2026.
  • Example: Existing authorization end date of January 20, 2026, a new authorization end date will be issued with March 1, 2026.
• Authorizations ending on or after March 2, 2026, will remain the same.

Telligen will issue new notices of decision to current BMC providers and send updated notices to members who have existing approved authorizations. 

• Providers can access the new authorization information in Telligen’s Qualitrac Provider Portal.

• Providers not yet enrolled with Telligen can complete registration via DocuSign in the Telligen Provider Portal Registration. For more information, visit Telligen's Idaho Medicaid website.  
  • The provider portion of the registration takes less than 10 minutes.
  • Any questions regarding the process may be sent to qtregistration@telligen.com.
• Providers unable to enroll with Telligen immediately should provide an updated mailing address to receive authorizations promptly by postal mail.
  • If a provider is already enrolled with Gainwell Technologies:
    • Login to your Trading Partner Account to confirm or update your mailing address.
  • If a provider is not already enrolled with Gainwell Technologies:
    • Contact Telligen provider support at IDMedicaidSupport@telligen.com to provide the correct mailing address to send via postal mail or email address to send via secure email.
    • Providers are encouraged to register with Gainwell Technologies Trading Partner Account as soon as possible.
      • Trading Partner Account Provider Not Yet Enrolled Registration Guide
      • Register 

The table below includes codes billed for Behavioral Modification and Consultation and Behavioral Intervention. The first column lists BMC codes billed to Magellan Healthcare; the second column lists the corresponding BI codes, billed to Gainwell Technologies using prior authorizations from Telligen. 

Yes. 

H0004 TG allows the Evidence Based Model (EBM) Intervention Professional, also known as a Board Certified Behavior Analysts (BCBA), to directly modify a treatment protocol.

This code can be used for direct face-to-face treatment, the time a professional spends face-to-face with a patient to actively assess the client's response and make real-time modifications to treatment strategies, and to directly modify a treatment protocol while directing a technician. 

• When directly modifying a treatment protocol while directing a technician, the provider overseeing the technician is the billing provider, not the technician. 

Providers must bill the primary insurance carrier using the appropriate Applied Behavioral Analysis codes, most commonly 97151–97159. After receiving the EOB showing the claim was submitted and either paid or denied, providers should then bill Idaho Medicaid. The Idaho Medicaid system includes a crosswalk for these codes to ensure proper payment.