1. A. The Program covers the services listed in this chapter when the services are:

   1. (1) Diagnosed, identified, and prescribed by an EPSDT provider to be medically necessary;
   2. (2) Preauthorized by the Department or its designee; and
   3. (3) Delivered in accordance with the behavioral plan.

2. B. The following services are covered:

   1. (1) Therapeutic behavioral assessment and reassessment that includes:

      1. (a) Development of a behavioral plan with the participant and parent, guardian, or individual who customarily provides care which specifically:

         1. (i) Identifies the target behaviors or symptoms that are placing the current living arrangement at risk or presenting a barrier to transition to a less restrictive living arrangement;
         2. (ii) Defines specific interventions to be used to resolve the behaviors or symptoms, including how a therapeutic aide will implement therapeutic behavioral services;
         3. (iii) Defines outcome measures that can be used to demonstrate the decreasing frequency of targeted behaviors;
         4. (iv) Defines alternative behaviors;
         5. (v) Defines the clinically accepted techniques for behavior change, including where, when, and the frequency of the techniques to be used and the risks and benefits of each;
         6. (vi) Details the strategies and skills for the participant and parent, guardian, or individual who customarily provides cares to provide continuity of care when therapeutic behavioral services are discontinued;
         7. (vii) Details emergency procedures to be implemented when the participant exhibits behaviors that pose harm to self or others;
         8. (viii) Contains written informed consent before implementation, of the parent or legal guardian, or if the participant is 18 years old or older, written informed consent of the participant; and
         9. (ix) Identifies the level or type of licensed healthcare professional responsible for monitoring the behavioral plan; and
      2. (b) Determination if therapeutic behavioral services are needed;

   2. (2) Therapeutic behavioral services that:

      1. (a) Provide one-to-one intervention for a specified period of time at the appropriate site in accordance with the behavioral plan; and

      2. (b) May include, but are not limited to:

         1. (i) Assisting the participant to engage in or remain engaged in appropriate activities;
         2. (ii) Minimizing the participant’s impulsive behavior;
         3. (iii) Providing immediate behavioral reinforcements;
         4. (iv) Providing time structuring activities; and
         5. (v) Collaboration with and support for parent, guardian, or individual who customarily provides care in the effort to provide ongoing behavioral support.

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Effective date: November 24, 2005 (32:23 Md. R. 1827)

Regulation .01B amended effective May 2, 2011 (38:9 Md. R. 552); December 12, 2022 (49:25 Md. R. 1050)

Regulation .02A amended effective February 15, 2016 (43:3 Md. R. 273); December 12, 2022 (49:25 Md. R. 1050)

Regulation .03B amended effective December 12, 2022 (49:25 Md. R. 1050)

Regulation .04 amended effective December 12, 2022 (49:25 Md. R. 1050)

Regulation .04D amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .06C amended effective February 15, 2016 (43:3 Md. R. 273); December 12, 2022 (49:25 Md. R. 1050); August 21, 2023 (50:16 Md. R. 726)