10.09.28.06

.06 Payment Procedures.

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 psychologist;

(3) Individual BCBA-D; and

(4) Individual BCBA.

C. Reimbursement for ABA services may not be made directly to a BCaBA or RBT rendering ABA services.

D. Reimbursement for ABA services may not be made to, or on behalf of services rendered by, the participantís parent or caregiver.

E. The Program shall pay for covered services:

(1) At the lesser of the providerís 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. Reimbursement for ABA services covered under this chapter is as follows:

(1) ABA assessment at a rate of $220;

(2) ABA exposure assessment at a rate of $75 per 30 minutes;

(3) ABA exposure modified treatment at a rate of:

(a) $150 for the first 60 minutes; and

(b) $75 per additional 30 minutes;

(4) ABA group treatment at a rate of:

(a) $15 per 30 minutes, per participant, when provided by a psychologist, BCBA-D, or BCBA;

(b) $12 per 30 minutes, per participant, when provided by a BCaBA; and

(c) $10 per 30 minutes, per participant, when provided by an RBT;

(5) ABA modified treatment at a rate of $55 per 30 minutes;

(6) ABA multiple-family group training at a rate of $37 per family;

(7) ABA parent training with the participant present at a rate of:

(a) $55 per 30 minutes when provided by a psychologist, BCBA-D, or BCBA; and

(b) $30 per 30 minutes when provided by a BCaBA;

(8) ABA parent training without the participant present at a rate of:

(a) $60 when provided by a psychologist, a BCBA-D, or a BCBA; and

(b) $35 when provided by a BCaBA;

(9) ABA reassessment at a rate of $55 per 30 minutes;

(10) ABA social skills group at a rate of $30 per participant;

(11) ABA supervision at a rate of $55 per 30 minutes;

(12) ABA treatment at a rate of:

(a) $35 per 30 minutes when provided by a psychologist, BCBA-D, or BCBA;

(b) $30 per 30 minutes when provided by a BCaBA; and

(c) $27.50 per 30 minutes when provided by an RBT; and

(13) ABA treatment planning:

(a) At a rate of $55 per 30 minutes; and

(b) For a maximum of 4 hours per month.