ABA Therapy Centers in Maryland

Maryland Medicaid Applied Behavior Analysis

Maryland Medicaid has covered ABA for members under 21 since January 1, 2017. A child qualifies with a diagnosis of autism spectrum disorder from a pediatrician, developmental pediatrician, nurse practitioner, pediatric neurologist, child psychiatrist, clinical psychologist or neuropsychologist. The diagnosing clinician refers the child, the state's behavioral health administrator preauthorizes services, and a psychologist or BCBA then writes the assessment and treatment plan. Authorizations last up to 180 days, and a reassessment is due before each renewal.

• Services must be delivered in the home and community, including clinics with a plan to generalize skills to the home.
• Every provider on the child's team must be enrolled in Maryland Medicaid.

Habilitative services law, § 15-835

Section 15-835 of the Insurance Article requires insurers, nonprofit health plans and HMOs to cover habilitative services for children until at least the end of the month they turn 19. For autism, the Insurance Administration lists applied behavior analysis among covered habilitative services. The Administration also states that plans may not limit coverage of medically necessary habilitative services, so a visit cap on ABA is not allowed. Plans are not required to pay for services already delivered through early intervention or school.

• Applies to policies issued or delivered in Maryland, including plans an employer bought in the state.
• Does not reach self-funded employer plans, federal employee plans or group policies issued in another state.

The Autism Waiver and Community Pathways

Maryland runs two separate waivers a family with an autistic child may hear about. The Autism Waiver, run by the State Department of Education for Medicaid, serves children from age 1 through the end of the school year they turn 21 who have an IEP or IFSP with at least 15 hours a week of services. It counts only the child's income and has a waitlist; call 866-417-3480 to join the registry. The DDA's Community Pathways Waiver is a different program with its own eligibility application, open to children and adults.

• Autism Waiver services include respite, intensive individual support, therapeutic integration and family consultation.
• Community Pathways services include behavior support, respite and family caregiver training.

Maryland Infants and Toddlers Program

The Maryland Infants and Toddlers Program serves children from birth through age two through 24 local programs. A child qualifies with a 25 percent delay in one developmental area, atypical development likely to cause a delay, or a diagnosed condition with a high probability of delay. Families refer online through the program's referral site. A child found eligible for preschool special education can stay on the IFSP past the third birthday under Maryland's Extended IFSP Option.

Who can deliver ABA in Maryland

Maryland licenses behavior analysts under Title 17, Subtitle 6A of the Health Occupations Article, through the Board of Professional Counselors and Therapists. For Medicaid ABA, BCBAs and BCBA-Ds must hold a Maryland license, and psychologists can also provide ABA. BCaBAs and RBTs deliver services under the supervision of a Maryland licensed BCBA or BCBA-D. Ask any provider for the supervising clinician's license number.