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 medical practice;

(6) Not replicative 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.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 14-24-083, § 182-531A-0300, filed 12/1/14, effective 1/1/15.]

RCW 41.05.021 and 41.05.160. WSR 14-24-083, § 182-531A-0300, filed 12/1/14, effective 1/1/15.

Rules

182-531A-0400,182-501,182-502,182-501,182-502,