Wash. Admin. Code § 182-531A-0300

Current through Register Vol. 24-23, December 1, 2024

Section 182-531A-0300 - Applied behavior analysis (ABA)-Threshold requirements

The medicaid agency pays for ABA services when the services are:

(1) Covered;

(2) Medically necessary;

(3) Within the scope of the eligible client's medical care program;

(4) Provided to clients who meet the criteria in WAC 182-531A-0400;

(5) Within currently accepted standards of evidence-based clinical practice;

(6) Not duplicative of ABA services paid for by other state agencies using medicaid funds;

(7) Completed in the stages described in this chapter;

(8) Provided by qualified health care professionals, as described in this chapter;

(9) Authorized, as required within this chapter, chapters 182-501 and 182-502 WAC, and the agency's Applied Behavior Analysis Provider Guide; and

(10) Billed according to this chapter, chapters 182-501 and 182-502 WAC, and the agency's Applied Behavior Analysis Provider Guide.

Wash. Admin. Code § 182-531A-0300

Adopted by WSR 14-24-083, Filed 12/1/2014, effective 1/1/2015

Amended by WSR 22-08-035, Filed 3/29/2022, effective 4/29/2022