Category Archives: Private Practice

• Medicaid Raises Limits on Number of Service Units that can be Billed per Day

  Posted on June 22, 2017 by CDEvanko in Policy, Private Practice, State Resources

  APBA, ABAI, Autism Speaks, and the BACB have been working hard to address some of the billing issues with the new T Codes.  They recently made great strides in getting the CMS (Centers for Medicaid & Medicare Services) to increase the allowable (billable) units per day.  Please click here for more information.

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• 2017 QMHP Registry Bill Impact on LBAs and LABAs

  Posted on March 13, 2017 by CDEvanko in Policy, Private Practice, RBT, State Resources

  Attention Licensed Behavior Analysts and Licensed Assistant Behavior Analysts who provide behavioral therapy through Medicaid:Recently a bill passed both the Senate and the House and is ready to be signed by the Governor (by 3/27).  This bill, SB1020/HB2095 seeks to provide a registry for Peer Recovery Specialists and Qualified Mental Health Professionals (QMHPs).  The definition […]

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• Latest information on Tricare ABA therapy changes for 2017

  Posted on January 8, 2017 by CDEvanko in Policy, Private Practice

  In 2016, advocates worked for 9 months to fight the reduction in Tricare’s ABA reimbursement rates (that went into effect in April 2016). Congress voted to reinstate rates to previous levels, effective 12/23/16. The National Defense Authorization Act (NDAA) passed last year. Current rates for direct treatment, as of 1/8/17, are $125 for BCBA-level professionals, […]

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• Attention Medicaid Providers!

  Posted on October 4, 2016 by CDEvanko in Miscellaneous, Policy, Private Practice

  Magellan put this out today regarding member eligibility. This message is sent to help prevent claim denials for eligibility. It is very important to check member eligibility for services provided before each visit. Two options are available: DMAS offers a web-based Internet option, the Automated Response System (ARS) to verify member eligibility. The Virginia Medicaid Web […]

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  Information about EPSDT Diagnosis Code Changes

  Posted on October 1, 2016 by CDEvanko in Miscellaneous, Policy, Private Practice, State Resources

  Attention VABA members who provide EPSDT Behavioral Therapy-Outpatient ABA services: Recently, Magellan of Virginia released news that as of October 1, 2016, the new ICD-10-CM codes updated for the fiscal year 2017 are required for use for all service requests, discharges, and reimbursements. At this time, it appears that there are no changes in codes […]

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• Virginia Health Practitioners’ Monitoring Program (HPMP)

  Posted on June 26, 2016 by CDEvanko in Miscellaneous, Private Practice, State Resources

  The Virginia Health Practitioners’ Monitoring Program (HPMP) helps to refer to treatment those practitioners (including behavior analysts) who suffer from impairing physical, mental health or substance abuse issue. See this flyer for details.

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• Law affecting coverage of ABA

  Posted on June 15, 2016 by CDEvanko in Private Practice, State Resources

  Click here to see a new law with an emergency clause that dials back the stated size of a small company from 100 to 50 as it was until January of this year.  Therefore, companies with 51 to 100 employees are still required to cover ABA for those diagnosed with autism spectrum disorder.

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• License Renewal Fees to Decrease

  Posted on January 11, 2016 by CDEvanko in Miscellaneous, Private Practice, State Resources

  According to the Board of Medicine’s January 2016 newsletter: FEE REDUCTION FOR RENEWALS IN 2016-2017 In 2013, the Board of Medicine voted to reduce renewal fees by approximately 14% for all its professions renewing in 2014 and 2015. The Board’s revenues have kept pace with its expenses, such that another reduction can be made for the […]

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• New Requirements for Medicaid – UPDATE

  Posted on January 5, 2016 by CDEvanko in Miscellaneous, Private Practice, RBT, State Resources

  Medicaid providers may have received a letter from Magellan Healthcare noting that they will require all ABA support staff to be Registered Behavioral Technicians (RBT) by April 30, 2016.  Questions can be directed to admin@virginiaaba.com or by calling the Magellan Provider Service Line at (800) 788-4005. UPDATE – This memo was for Magellan corporate accounts […]

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• Early Intervention Services – Be a Provider!

  Posted on November 29, 2015 by CDEvanko in Education, Miscellaneous, Private Practice, State Resources

  In December of 2014, LBAs and LABAs were authorized to provide Early Intervention Services through the Commonwealth. Please see this presentation for basic information about the change. To apply to be a provider, see this information sheet. Megan Sullivan Kirby, BCBA, LBA and Leigh Martinez, SLP, BCBA, LBA put together this helpful document on how […]

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