Number of Pages: 18
 
Format: Word Template (.dotx)
 
Who is it for?
BCBA
 
What is it?
This document contains 2 treatment plan templates. One for Initial Treatment Plan, and another one for Updated Treatment Plan 
The template includes the following sections that are commonly required by payors in order to obtain authorizations:
Member, provider, client identification information
Request for treatment hours
Description of service: ABA service, related service, and care coordination
Report of school schedule
Description of case supervision
Description of caregiver training
Intake Assessment Summary (for initial treatment plan)
Summary of progress and summary of challenges (for updated treatment plan)
Chief complaints from guardians
Medical histories
Family background
Assessment summary
Individualized treatment goals (and report of data/graph)
Service hours fading critieria (*sample description is included, but user's edit is advised)
Discharge criteria (*sample description is included, but user's edit is advised)
Treatment plan consent form
 
Why should you use it?
Treatment plan is often required to obtain ABA service authorization from payors.
A treatment plan also summarizes the cilent's progress during a given period of time