<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.09.28.06" title_num="10" subtitle_num="09" chapter_num="28" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>The provider shall follow all procedures in accordance with COMAR 10.09.36.</text>
  </paragraph>
  <paragraph num="B.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>ABA program;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Individual licensed psychologist; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Individual LBA.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Reimbursement for ABA services may not be made directly to a BCaBA, RBT, or BT rendering ABA services.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Reimbursement for ABA services may not be made to, or on behalf of services rendered by, the participant's parent or caregiver.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The Program shall pay for covered services:</text>
    <paragraph num="(1)">
      <text>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</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In accordance with COMAR 10.09.36.06.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Effective July 1, 2022 through June 30, 2023, reimbursement for ABA services covered under this chapter is as follows:</text>
    <paragraph num="(1)">
      <text>Behavior identification assessment at a rate of $33.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Behavior identification assessment follow-up at a rate of $16.73 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Exposure behavior identification supporting assessment at a rate of $45.63 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adaptive exposure behavior treatment with protocol modification at a rate of $45.63 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Group adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$9.13 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$7.30 per 15 minutes, per participant, when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$6.08 per 15 minutes, per participant, when provided by an RBT or BT;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Adaptive behavior treatment with protocol modification at a rate of $33.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Multiple-family group adaptive behavior treatment guidance at a rate of $11.26 per 15 minutes per family;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Family adaptive behavior treatment guidance with the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$33.46 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$18.25 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Family adaptive behavior treatment guidance without the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$18.25 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$10.65 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Behavior identification reassessment at a rate of $33.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Group adaptive treatment with protocol modification at a rate of $9.13 per 15 minutes per participant;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Adaptive behavior treatment direction at a rate of $33.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$21.30 per 15 minutes when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$18.25 per 15 minutes when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$16.73 per 15 minutes when provided by an RBT or BT; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>Adaptive behavior treatment planning:</text>
      <paragraph num="(a)">
        <text>At a rate of $33.46 per 15 minutes; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For a maximum of 4 hours per month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Effective July 1, 2023 through December 31, 2023, reimbursement for ABA services covered under this chapter is as follows:</text>
    <paragraph num="(1)">
      <text>Behavior identification assessment at a rate of $34.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Behavior identification assessment follow-up at a rate of $17.23 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Exposure behavior identification supporting assessment at a rate of $47.00 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adaptive exposure behavior treatment with protocol modification at a rate of $47.00 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Group adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$9.40 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$7.52 per 15 minutes, per participant, when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$6.26 per 15 minutes, per participant, when provided by an RBT or BT;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Adaptive behavior treatment with protocol modification at a rate of $33.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Multiple-family group adaptive behavior treatment guidance at a rate of $11.60 per 15 minutes per family;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Family adaptive behavior treatment guidance with the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$34.46 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$18.80 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Family adaptive behavior treatment guidance without the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$18.80 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$10.97 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Behavior identification reassessment at a rate of $34.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Group adaptive treatment with protocol modification at a rate of $9.40 per 15 minutes per participant;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Adaptive behavior treatment direction at a rate of $34.46 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$21.94 per 15 minutes when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$18.80 per 15 minutes when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$17.23 per 15 minutes when provided by an RBT or BT; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>Adaptive behavior treatment planning:</text>
      <paragraph num="(a)">
        <text>At a rate of $34.46 per 15 minutes; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For a maximum of 4 hours per month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Effective January 1, 2024 through June 30, 2024, reimbursement for ABA services covered under this chapter is as follows:</text>
    <paragraph num="(1)">
      <text>Behavior identification assessment at a rate of $37.22 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Behavior identification assessment follow-up at a rate of $18.61 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Exposure behavior identification supporting assessment at a rate of $50.76 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adaptive exposure behavior treatment with protocol modification at a rate of $50.76 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Group adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$10.15 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$8.12 per 15 minutes, per participant, when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$6.76 per 15 minutes, per participant, when provided by an RBT or BT;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Adaptive behavior treatment with protocol modification at a rate of $37.22 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Multiple-family group adaptive behavior treatment guidance at a rate of $12.53 per 15 minutes per family;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Family adaptive behavior treatment guidance with the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$37.22 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$20.30 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Family adaptive behavior treatment guidance without the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$20.30 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$11.85 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Behavior identification reassessment at a rate of $37.22 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Group adaptive treatment with protocol modification at a rate of $10.15 per 15 minutes per participant;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Adaptive behavior treatment direction at a rate of $37.22 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$23.70 per 15 minutes when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$20.30 per 15 minutes when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$18.61 per 15 minutes when provided by an RBT or BT; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>Adaptive behavior treatment planning:</text>
      <paragraph num="(a)">
        <text>At a rate of $37.22 per 15 minutes; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For a maximum of 4 hours per month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Effective July 1, 2024, reimbursement for ABA services covered under this chapter is as follows:</text>
    <paragraph num="(1)">
      <text>Behavior identification assessment at a rate of $38.34 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Behavior identification assessment follow-up at a rate of $19.17 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Exposure behavior identification supporting assessment at a rate of $52.28 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adaptive exposure behavior treatment with protocol modification at a rate of $52.28 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Group adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$10.45 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$8.36 per 15 minutes, per participant, when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$6.96 per 15 minutes, per participant, when provided by an RBT or BT;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Adaptive behavior treatment with protocol modification at a rate of $38.34 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Multiple-family group adaptive behavior treatment guidance at a rate of $12.91 per 15 minutes per family;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Family adaptive behavior treatment guidance with the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$38.34 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$20.91 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Family adaptive behavior treatment guidance without the participant present at a rate of:</text>
      <paragraph num="(a)">
        <text>$20.91 per 15 minutes when provided by a licensed psychologist or an LBA; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$12.21 per 15 minutes when provided by a BCaBA;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Behavior identification reassessment at a rate of $38.34 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Group adaptive treatment with protocol modification at a rate of $10.45 per 15 minutes per participant;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Adaptive behavior treatment direction at a rate of $38.34 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Adaptive behavior treatment by protocol at a rate of:</text>
      <paragraph num="(a)">
        <text>$24.41 per 15 minutes when provided by a licensed psychologist or an LBA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>$20.91 per 15 minutes when provided by a BCaBA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>$19.17 per 15 minutes when provided by an RBT or BT; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>Adaptive behavior treatment planning:</text>
      <paragraph num="(a)">
        <text>At a rate of $38.34 per 15 minutes; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For a maximum of 4 hours per month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>