TennCare Select is not a fourth TennCare MCO alongside BlueCare, UnitedHealthcare Community Plan, and Wellpoint — it's a separate state contract. TennCare Select operates as a Prepaid Inpatient Health Plan (PIHP) under its own agreement between the Division of TennCare and Volunteer State Health Plan, Inc. (d/b/a BlueCare Tennessee) — a distinct Edison contract ID from BlueCare's own MCO contract, even though both are run by the same BlueCross BlueShield of Tennessee subsidiary. Members don't choose TennCare Select; TennCare assigns them to it because they fall into specific categories — children receiving SSI, children in DCS (foster care) custody, enrollees in intellectual-disability HCBS waivers, and a handful of statewide safety-net groups. For ABA, the clinical rules are the same shared tri-MCO program covered in our main TennCare guide — what's different here is the population TennCare Select serves and the phone/fax/contact structure built around it.
The state's own contract text describes it plainly: "The Contractor shall operate under and market the services delivered via the prepaid Inpatient Health Plan (PIHP) as 'TennCare Select.'" That PIHP agreement (Edison Contract ID 83332, term 1/1/2025–12/31/2027) is separate from BlueCare Tennessee's standard MCO contract, though both sit with Volunteer State Health Plan. BlueCare Tennessee's own Provider Administration Manual confirms the setup: "TennCareSelect is the State's self-insured TennCare Health Maintenance Organization... administered by BlueCare Tennessee... Enrollees cannot choose TennCareSelect as their TennCare MCO; TennCare members assigned to the TennCareSelect MCO must meet certain criteria and must be assigned to the TennCareSelect MCO by the Division of TennCare." For ABA specifically, the same PAM section covers both BlueCare and TennCareSelect members under one shared policy — the same CPT codes (97151–97155, 0362T, 0373T), the same RBT/BCaBA/BCBA billing structure, and the same tri-MCO baseline (26-week authorization periods, severity-level justification, no fixed annual hour cap) that governs the rest of TennCare. Practically: if a family is on TennCare Select, plan clinically exactly as you would for BlueCare — the differences that matter are contact numbers and, for a subset of members, LTSS-specific programs. This structure is independently confirmed in the generic TennCare MCO Statewide Contract template (now current through Amendment 25, effective July 1, 2026, per its own cover page), which defines TennCare Select as a statewide backup MCO whose risk the State of Tennessee backs — created for MCO failure/inadequate-capacity scenarios and as the assigned plan for children in state custody and SSI-eligible children (who may opt out).[1][9][2]
TennCare assigns — rather than lets members pick — enrollees who fall into defined categories: children under 21 who are SSI-eligible; children in DCS (foster care) custody and those transitioning out of custody (branded "SelectKids"); enrollees receiving services in an institution or an HCBS 1915(c) waiver for intellectual disabilities; enrollees living out-of-state; enrollees TennCare couldn't contact; and members of the "Integrated Health Services Delivery Model" target population for intellectual disabilities, branded "SelectCommunity" — largely 1915(c) waiver enrollees and former ICF/IID ("Arlington class") residents. TennCare Select is also the sole administrator of the Katie Beckett Program Part A (non-Medicaid-eligible-by-income children with significant disabilities up to 18). For an ABA intake team, the practical read is: TennCare Select skews toward higher-acuity, higher-support-need members — foster youth, IDD/CHOICES populations, and SSI kids — more than a random cross-section of TennCare.[2]
TennCare's own Managed Care Program Annual Report (MCPAR), submitted to CMS on 6/29/2025 for reporting period CY2024, lists average monthly enrollment across TennCare's four managed-care products: Wellpoint Tennessee 438,735; BlueCare Tennessee 552,517; UnitedHealthcare Community Plan 439,049; and TennCare Select 37,095 — about 2.5% of statewide TennCare enrollment. That's the most current figure independently confirmed against a primary source; TennCare also publishes monthly enrollment spreadsheets that may carry a more current number, but those weren't retrievable during this review — treat 37,095 as the latest verified figure, not necessarily the latest available one.[3]
ABA requests use the shared tri-MCO universal request form, submitted through Availity for in-state providers or Cohere for out-of-state providers; PA questions route to (423) 535-5717, option 2. Two BCBST-hosted ABA forms — an "ABA Therapy Services Assessment Request Form" and an "Initiation and Continuation of ABA Therapy Form" (the latter confirming the 26-week/6-month certification period and a severity-level 1–3 field) — surfaced in this review, consistent with the tri-MCO baseline, but neither form's text explicitly labels itself TennCare Select-specific versus a general BCBST form; confirm the exact required form with BlueCare/TennCare Select provider relations before submitting. What is confirmed distinct is the contact structure: TennCare Select runs its own Member Service Line (1-800-263-5479, vs. BlueCare's 1-800-468-9698), Provider Service Line (1-800-276-1978, vs. 1-800-468-9736), and Prior Auth phone (1-800-711-4104, vs. BlueCare's 1-888-423-0131) — though the PA fax (1-800-292-5311) is shared with BlueCare. SelectKids (the foster-care population) carries its own further layer: Provider/Family Services at 1-800-451-9147 (fax 1-800-330-2842) and Member Services at 1-888-422-2963. SelectCommunity (the IDD population) has its own line, 1-800-292-8196 (fax 1-888-255-9175).[2][6][7]
TennCare Select is the exclusive administrator of SelectCommunity and Katie Beckett Part A, and shares CHOICES/ECF CHOICES LTSS administration with BlueCare — the MLTSS Provider Manual states plainly that "all BlueCare/TennCare Select billing guidelines apply" for these populations. That matters for staffing: TennCare's Aligned Background Check Protocol (effective July 1, 2024) governs providers serving 1915(c) waiver, Katie Beckett, Employment and Community First CHOICES, and CHOICES members — criminal background checks plus registry screening (TN Abuse Registry, National/TN Sex Offender Registry, LEIE, SAM, TennCare Terminated Provider List) within 30 days before first contact, monthly SAM/LEIE/TTPL rechecks. The protocol document itself refers generically to "Managed Care Organizations" rather than naming TennCare Select, but because TennCare Select administers exactly these programs, any ABA agency serving a TennCare Select family through SelectCommunity, ECF CHOICES, or Katie Beckett falls under it — the same guidance our main TennCare guide gives: if you serve Katie Beckett or CHOICES children, run the full protocol for everyone rather than trying to split by plan.[4][5]
The questions that decide whether a family can start with TennCare Select, and what they have to bring. Each maps onto something intake should ask on the first call.
Follows the TennCare rule: EPSDT covers “children from birth through age 20 who have TennCare,” and the shared tri-MCO program description sets no age of its own. TennCare Select’s population skews younger and higher-acuity — SSI children under 21, DCS custody youth, Katie Beckett Part A children up to 18 — but the ABA age boundary is the state’s.[10][11][2]
Follows the TennCare rule: no recency limit on the ASD diagnosis, with updated evaluation of functioning by standardized tools expected at least every two years, and 26-week (six-month) certification periods. The BCBST forms that serve TennCare Select members ask for “Initial/First Date ASD Diagnosed” and the DSM severity level (1–3) without capping the report’s age; continuation requests “must be submitted at least once every six months.”[11][7]
Follows the TennCare rule — the diagnosis must come from “a qualified health professional, practicing within their scope, with training in assessment of individuals with ASD and/or other neurodevelopmental concerns,” with a TN-licensed clinician documenting medical necessity. No TennCare Select-specific diagnostician rule exists; the BCBST forms ask only for diagnostic confirmation and severity level.[11][6]
Follows the TennCare rule: no named instrument, but the diagnosis must be validated by a documented comprehensive assessment against DSM-5-TR criteria, and the ABA assessment must include direct observation, file review, informant interviews and standardized assessments across cognition, communication, social, adaptive and behavioral domains. BCBST’s forms capture severity level and measurable goals rather than a required test battery.[11][7]
Follows the TennCare rule — the assessment request needs the diagnostic report plus a doctor’s order; the BCBST forms ask for “diagnostic confirmation like diagnostic reports, doctor’s orders, etc.” TennCare Select-specific mechanics: Tennessee providers submit in Availity, out-of-state providers through Cohere, and PA questions route to (423) 535-5717, option 2, with TennCare Select’s own prior-auth line at 1-800-711-4104 (fax 1-800-292-5311 is shared with BlueCare).[6][7][11]
Follows the TennCare rule: telehealth hours are requested per code on the universal tri-MCO form, which carries a telehealth checkbox on every ABA code row and lists Telehealth among the places of service. No TennCare Select-specific ABA telehealth policy was located — the BCBST forms collect proposed service locations without a telehealth rule of their own — so the shared program description’s appropriateness, HIPAA and competence cautions govern.[8][11][6]
TennCareSelect is administered by BlueCare Tennessee, and the shared July 2026 BlueCare Tennessee manual governs it: for a standard request, BlueCare "will provide notice as expeditiously as the member's condition requests and within State-established timeframes that may not exceed 7 calendar days following the receipt of the request for service." It may add "up to 14 additional calendar days" if the member or provider asks, or if BlueCare justifies needing more information. Expedited requests are decided "no later than 72 hours after the receipt of the request for service." That 72 hours can also stretch by up to 14 days on the same grounds. The clock runs from receipt. BlueCare's ABA form says continuation requests "must be submitted at least once every six months" (26-week periods) but sets no lead time before expiry.[2][9][7]
Other coverage is routine on TennCareSelect. Children in Katie Beckett Part A "must have a primary payer or third-party liability (TPL) that will be their first payor with Medicaid paying secondary," and TennCareSelect is their plan. BlueCare, TennCareSelect and CoverKids "are always the payers of last resort." Bill the commercial plan first. The secondary claim must carry "the primary payer's explanation of benefits" and must be "received within 120 days from the date the primary insurer's remittance was produced." BlueCare pays only the gap up to its own allowed amount: if the other carrier paid at or above BlueCare's allowable, "BCT will make no additional reimbursement." Pay-and-chase exception: claims for "TennCare Kids," "Preventive pediatric care," all CoverKids members under 21, and absent-parent insurance "will not be denied for a primary carrier's EOB." BlueCare pays and recovers from the other plan, though the manual notes billing the other carrier first earns "the higher reimbursement rate." The manual does not say whether an ABA claim counts as "TennCare Kids." It also says to seek the primary insurer's prior authorization first only when BlueCare is secondary to Medicare. It is silent on a commercial primary. The TennCare contract lets the MCO deny a claim the primary denied for "failure to obtain prior authorization." Get the commercial PA, and confirm with BlueCare whether its own ABA PA is still needed. TRICARE by statute pays only after other coverage "except in the case of a plan administered under title XIX" (Medicaid), so TRICARE goes before TennCare. CHAMPVA is the reverse: "If you are eligible under Medicaid, CHAMPVA will pay first."[2][9][12][13]
Ask the plan: BlueCare Tennessee Provider Service / UM (Availity) — ask whether an ABA claim falls under the "TennCare Kids" pay-and-chase line, and whether TennCareSelect wants its own ABA authorization when a commercial plan is primary.
Coverage decides whether TennCare Select pays. These decide whether the claim survives: how sessions must be staffed and supervised, what may be billed concurrently, the per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under.
Follows the TennCare rule: direct ABA must be delivered or supervised by a TN Licensed Behavior Analyst (or a health professional permissible under TN law), unlicensed persons work under the LBA’s extended authority and direction, and RBTs with their supervising BCBAs must meet all current BACB supervision requirements — the operative floor being 5% of monthly service hours with two face-to-face contacts. One TennCare Select-specific staffing overlay matters more than the ratio: members in CHOICES, ECF CHOICES, 1915(c) waivers or Katie Beckett trigger TennCare’s Aligned Background Check Protocol for every employee with direct member contact.[11][2]
No per-day ceiling and no annual benefit limit. Authorizations run 26 weeks and the BCBST initiation/continuation form asks for hours per week by code plus a clinical justification for any increase and, “if concurrent,” hours approved versus hours used in the last authorization period — the same sub-90% utilization discipline the whole program applies to 97153. Group sizes are capped as best practice at six to eight participants.[7][11]
Follows the TennCare rule — Clinic, Home, Community, School, Telehealth and Other are all requestable, and medically necessary school-based behavioral health services need not be in an IEP to be reimbursable; IEP services and functioning as an educational aide stay non-covered. BCBST’s assessment form asks providers to state the “proposed location(s)” where ABA will be delivered, so setting is authorized rather than assumed.[11][8][6]
Follows the TennCare rule — the claim rides on the group or servicing provider, with practitioner level carried as a modifier (HO analyst-delivered, HM technician-delivered, 97153 split). BlueCare’s Provider Administration Manual covers BlueCare and TennCareSelect members under one shared ABA policy with the same codes (97151–97155, 0362T, 0373T) and the same RBT/BCaBA/BCBA billing structure, and the BCBST forms collect “Provider ID, NPI Number, or Tax ID.” Rates are contract-negotiated.[2][8][7]
Not answered for 97153 with 97155. The shared program description bars only more than one licensed analyst serving a member during a specific time interval and ABA delivered simultaneously with OT, speech, PT or psychotherapy; BlueCare’s own form states the converse for scheduling — “the hours per week authorized aren’t inclusive of other services being provided.”[11][7]
Ask the plan: TennCare Select prior auth 1-800-711-4104 or (423) 535-5717 option 2, and the BlueCare Tennessee Provider Administration Manual’s ABA and claim-editing sections.
No session-note co-signature rule is published. The BCBST forms close with a provider signature, printed name and credentials plus an attestation that all pertinent clinical information was supplied — a request-level rule. The program description otherwise relies on BACB record-storage and retention standards, with treatment plans due within 30 days of admission and reviewed every six months.[7][6][11]
Blocked on: The BlueCare Tennessee Provider Administration Manual’s record-documentation section, or TennCare Select provider services 1-800-276-1978.
No — they're separate state contracts (different Edison contract IDs) even though both are administered by Volunteer State Health Plan, a BlueCross BlueShield of Tennessee subsidiary. Members are assigned to TennCare Select by the Division of TennCare, not chosen; contact numbers and some LTSS programs differ.
SSI-eligible children under 21, children in DCS foster-care custody ("SelectKids"), members in intellectual-disability HCBS waivers ("SelectCommunity"), Katie Beckett Part A children, and some out-of-state or safety-net enrollees — roughly 37,095 members statewide (CY2024 average).
Yes — the same shared tri-MCO ABA program that governs BlueCare, UnitedHealthcare Community Plan, and Wellpoint: EPSDT members under 21, prior authorization on assessment and treatment, TN Licensed Behavior Analyst licensure, 26-week authorization periods.
The shared tri-MCO universal ABA request form, via Availity (Tennessee providers) or Cohere (out-of-state providers). TennCare Select's own Provider Service Line is 1-800-276-1978 and PA phone is 1-800-711-4104 — both distinct from BlueCare's numbers.
Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed September 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.
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