- A. The provider shall follow all procedures in accordance with COMAR 10.09.36.
B. The Program shall provide fee-for-service reimbursement for covered ABA services to the following ABA providers who meet the conditions for participation set forth in Regulation .02 of this chapter:
- (1) ABA program;
- (2) Individual licensed psychologist; and
- (3) Individual LBA.
- C. Reimbursement for ABA services may not be made directly to a BCaBA, RBT, or BT rendering ABA services.
- D. Reimbursement for ABA services may not be made to, or on behalf of services rendered by, the participant's parent or caregiver.
E. The Program shall pay for covered services:
- (1) At the lesser of the provider's customary charge to the general public unless the services are free to the individuals not covered by Medicaid; or
- (2) In accordance with COMAR 10.09.36.06.
F. Effective July 1, 2022 through June 30, 2023, reimbursement for ABA services covered under this chapter is as follows:
- (1) Behavior identification assessment at a rate of $33.46 per 15 minutes;
- (2) Behavior identification assessment follow-up at a rate of $16.73 per 15 minutes;
- (3) Exposure behavior identification supporting assessment at a rate of $45.63 per 15 minutes;
- (4) Adaptive exposure behavior treatment with protocol modification at a rate of $45.63 per 15 minutes;
(5) Group adaptive behavior treatment by protocol at a rate of:
- (a) $9.13 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;
- (b) $7.30 per 15 minutes, per participant, when provided by a BCaBA; and
- (c) $6.08 per 15 minutes, per participant, when provided by an RBT or BT;
- (6) Adaptive behavior treatment with protocol modification at a rate of $33.46 per 15 minutes;
- (7) Multiple-family group adaptive behavior treatment guidance at a rate of $11.26 per 15 minutes per family;
(8) Family adaptive behavior treatment guidance with the participant present at a rate of:
- (a) $33.46 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $18.25 per 15 minutes when provided by a BCaBA;
(9) Family adaptive behavior treatment guidance without the participant present at a rate of:
- (a) $18.25 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $10.65 per 15 minutes when provided by a BCaBA;
- (10) Behavior identification reassessment at a rate of $33.46 per 15 minutes;
- (11) Group adaptive treatment with protocol modification at a rate of $9.13 per 15 minutes per participant;
- (12) Adaptive behavior treatment direction at a rate of $33.46 per 15 minutes;
(13) Adaptive behavior treatment by protocol at a rate of:
- (a) $21.30 per 15 minutes when provided by a licensed psychologist or an LBA;
- (b) $18.25 per 15 minutes when provided by a BCaBA; and
- (c) $16.73 per 15 minutes when provided by an RBT or BT; and
(14) Adaptive behavior treatment planning:
- (a) At a rate of $33.46 per 15 minutes; and
- (b) For a maximum of 4 hours per month.
G. Effective July 1, 2023 through December 31, 2023, reimbursement for ABA services covered under this chapter is as follows:
- (1) Behavior identification assessment at a rate of $34.46 per 15 minutes;
- (2) Behavior identification assessment follow-up at a rate of $17.23 per 15 minutes;
- (3) Exposure behavior identification supporting assessment at a rate of $47.00 per 15 minutes;
- (4) Adaptive exposure behavior treatment with protocol modification at a rate of $47.00 per 15 minutes;
(5) Group adaptive behavior treatment by protocol at a rate of:
- (a) $9.40 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;
- (b) $7.52 per 15 minutes, per participant, when provided by a BCaBA; and
- (c) $6.26 per 15 minutes, per participant, when provided by an RBT or BT;
- (6) Adaptive behavior treatment with protocol modification at a rate of $33.46 per 15 minutes;
- (7) Multiple-family group adaptive behavior treatment guidance at a rate of $11.60 per 15 minutes per family;
(8) Family adaptive behavior treatment guidance with the participant present at a rate of:
- (a) $34.46 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $18.80 per 15 minutes when provided by a BCaBA;
(9) Family adaptive behavior treatment guidance without the participant present at a rate of:
- (a) $18.80 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $10.97 per 15 minutes when provided by a BCaBA;
- (10) Behavior identification reassessment at a rate of $34.46 per 15 minutes;
- (11) Group adaptive treatment with protocol modification at a rate of $9.40 per 15 minutes per participant;
- (12) Adaptive behavior treatment direction at a rate of $34.46 per 15 minutes;
(13) Adaptive behavior treatment by protocol at a rate of:
- (a) $21.94 per 15 minutes when provided by a licensed psychologist or an LBA;
- (b) $18.80 per 15 minutes when provided by a BCaBA; and
- (c) $17.23 per 15 minutes when provided by an RBT or BT; and
(14) Adaptive behavior treatment planning:
- (a) At a rate of $34.46 per 15 minutes; and
- (b) For a maximum of 4 hours per month.
H. Effective January 1, 2024 through June 30, 2024, reimbursement for ABA services covered under this chapter is as follows:
- (1) Behavior identification assessment at a rate of $37.22 per 15 minutes;
- (2) Behavior identification assessment follow-up at a rate of $18.61 per 15 minutes;
- (3) Exposure behavior identification supporting assessment at a rate of $50.76 per 15 minutes;
- (4) Adaptive exposure behavior treatment with protocol modification at a rate of $50.76 per 15 minutes;
(5) Group adaptive behavior treatment by protocol at a rate of:
- (a) $10.15 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;
- (b) $8.12 per 15 minutes, per participant, when provided by a BCaBA; and
- (c) $6.76 per 15 minutes, per participant, when provided by an RBT or BT;
- (6) Adaptive behavior treatment with protocol modification at a rate of $37.22 per 15 minutes;
- (7) Multiple-family group adaptive behavior treatment guidance at a rate of $12.53 per 15 minutes per family;
(8) Family adaptive behavior treatment guidance with the participant present at a rate of:
- (a) $37.22 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $20.30 per 15 minutes when provided by a BCaBA;
(9) Family adaptive behavior treatment guidance without the participant present at a rate of:
- (a) $20.30 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $11.85 per 15 minutes when provided by a BCaBA;
- (10) Behavior identification reassessment at a rate of $37.22 per 15 minutes;
- (11) Group adaptive treatment with protocol modification at a rate of $10.15 per 15 minutes per participant;
- (12) Adaptive behavior treatment direction at a rate of $37.22 per 15 minutes;
(13) Adaptive behavior treatment by protocol at a rate of:
- (a) $23.70 per 15 minutes when provided by a licensed psychologist or an LBA;
- (b) $20.30 per 15 minutes when provided by a BCaBA; and
- (c) $18.61 per 15 minutes when provided by an RBT or BT; and
(14) Adaptive behavior treatment planning:
- (a) At a rate of $37.22 per 15 minutes; and
- (b) For a maximum of 4 hours per month.
I. Effective July 1, 2024, reimbursement for ABA services covered under this chapter is as follows:
- (1) Behavior identification assessment at a rate of $38.34 per 15 minutes;
- (2) Behavior identification assessment follow-up at a rate of $19.17 per 15 minutes;
- (3) Exposure behavior identification supporting assessment at a rate of $52.28 per 15 minutes;
- (4) Adaptive exposure behavior treatment with protocol modification at a rate of $52.28 per 15 minutes;
(5) Group adaptive behavior treatment by protocol at a rate of:
- (a) $10.45 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;
- (b) $8.36 per 15 minutes, per participant, when provided by a BCaBA; and
- (c) $6.96 per 15 minutes, per participant, when provided by an RBT or BT;
- (6) Adaptive behavior treatment with protocol modification at a rate of $38.34 per 15 minutes;
- (7) Multiple-family group adaptive behavior treatment guidance at a rate of $12.91 per 15 minutes per family;
(8) Family adaptive behavior treatment guidance with the participant present at a rate of:
- (a) $38.34 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $20.91 per 15 minutes when provided by a BCaBA;
(9) Family adaptive behavior treatment guidance without the participant present at a rate of:
- (a) $20.91 per 15 minutes when provided by a licensed psychologist or an LBA; and
- (b) $12.21 per 15 minutes when provided by a BCaBA;
- (10) Behavior identification reassessment at a rate of $38.34 per 15 minutes;
- (11) Group adaptive treatment with protocol modification at a rate of $10.45 per 15 minutes per participant;
- (12) Adaptive behavior treatment direction at a rate of $38.34 per 15 minutes;
(13) Adaptive behavior treatment by protocol at a rate of:
- (a) $24.41 per 15 minutes when provided by a licensed psychologist or an LBA;
- (b) $20.91 per 15 minutes when provided by a BCaBA; and
- (c) $19.17 per 15 minutes when provided by an RBT or BT; and
(14) Adaptive behavior treatment planning:
- (a) At a rate of $38.34 per 15 minutes; and
- (b) For a maximum of 4 hours per month.
Authority: Health-General Article, §§2-104(b), 2-105(b), 15-103, and 15-105, Annotated Code of Maryland
Effective date: November 7, 2016 (43:22 Md. R. 1218)
Regulation .01B amended effective March 12, 2018 (45:5 Md. R. 285); June 17, 2019 (46:12 Md. R. 542); December 12, 2022 (49:25 Md. R. 1049); December 11, 2023 (50:24 Md. R. 1041)
Regulation .02A amended effective December 12, 2022 (49:25 Md. R. 1049)
Regulation .02H, I amended effective June 17, 2019 (46:12 Md. R. 542); December 12, 2022 (49:25 Md. R. 1049)
Regulation .02J adopted effective December 11, 2023 (50:24 Md. R. 1041)
Regulation .03B amended effective June 17, 2019 (46:12 Md. R. 542); December 12, 2022 (49:25 Md. R. 1049)
Regulation .04 amended effective December 12, 2022 (49:25 Md. R. 1049)
Regulation .04B amended effective March 12, 2018 (45:5 Md. R. 285); June 17, 2019 (46:12 Md. R. 542); December 11, 2025 (52:24 Md. R. 1197
Regulation .04B, C amended effective December 11, 2023 (50:24 Md. R. 1041)
Regulation .05B, C amended effective March 12, 2018 (45:5 Md. R. 285)
Regulation .05D amended effective December 12, 2022 (49:25 Md. R. 1049)
Regulation .05F adopted effective March 12, 2018 (45:5 Md. R. 285)
Regulation .06 amended effective March 12, 2018 (45:5 Md. R. 285); December 11, 2023 (50:24 Md. R. 1041); December 11, 2025 (52:24 Md. R. 1197)
Regulation .06B amended effective December 12, 2022 (49:25 Md. R. 1049)
Regulation .06F amended effective June 17, 2019 (46:12 Md. R. 542); December 12, 2022 (49:25 Md. R. 1049)
Regulation .06G adopted effective December 12, 2022 (49:25 Md. R. 1049)