ABA - Frequently Asked Questions
ABA - Frequently Asked Questions
Q: Is testing for Autism Spectrum Disorders Continuing in Kent County?
Yes, initial testing scheduled with Network180 contract providers is continuing. Some annual evaluations have been postponed and will be rescheduled.
A: Is ABA Treatment Continuing?
Some agencies have chosen to suspend all face to face services both in home and center based. Others have decided to continue with both center-based and in-home services.
Those continuing center-based ABA services are following CDC guidelines and implementing the following:
- Performing stringent cleaning policies for the centers
- Sanitizing the therapy room and materials between sessions
- Practicing social distancing
- Screening checklist for all staff and visitors at the center prior to entering.
- Limiting one parent/family member to drop off and pick up.
Q: Can Telehealth be Offered to Families?
A: Yes. The state has approved all of the ABA codes (except 97153 and 97154) to be billed as telehealth. Please see Code Chart for COVID-19 Crisis on our website.
Q: With the current COVID-19 situation, some questions have arisen in our region regarding requirements regarding waiver programs and the Autism benefit.
A: MDHHS is currently pursuing all available options to address this through federally approved channels. These channels includes flexibilities that enable states to waive prior authorization requirements to remove barriers to needed services, streamline provider enrollment processes to ensure access to care for beneficiaries, allow care to be provided in alternative settings in the event a facility is evacuated to an unlicensed facility, suspend certain nursing home screening requirements to provide necessary administrative relief, and extend deadlines for appeals and state fair hearing requests. These flexibilities will enable the state to focus its resources on combatting this outbreak and provide the best possible care to Medicaid beneficiaries in Michigan.
- MI Appendix K for all three 1915(c) waivers (CWP, HSW, and SEDW)
- MI is pursing approval to waive certain requirements in Medicaid, and CHIP under Section 1135 authority.
- This authority would impact all the behavioral health covered state plan services, including EPSDT/ABA services.
Q: What are some good resources to assist ABA providers in understanding the rules around telehealth?
A: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification- enforcement-discretion-telehealth/index.html
- Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency. Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.
Q: How Does an Agency get Approval for Telehealth?
A: The system will auto-generate a blanket “COVID-19 prior authorization” for 97156 (Family Training) and 97155 (Observation & Direction) for all enrolled beneficiaries for the time period of March 1, 2020 through March 1, 2021. This will pre-populate a row in the telepractice tab for the allowed use of this option if they choose to use it during this period of time. Additional details will be forthcoming as they build and test.
Q: Will ABA direct service be allowed telepractice?
Q: Can parent training hours be increased if choosing to not continue in ABA training due to COVID-19?
A: Network180 is implementing the following process for increased parent training requests due to the COVID-19. This form is ONLY needed if you need increased units for 97156 . Network180 does not need a form if you are doing telepractice and are not requesting more units.
- ABA provider completes the Parent Training Increase Request form and sends it to the supports coordinator and Paige at Netrwork180
- Supports coordinator will add the units to the IPOS
- Network180 will modify the current authorization with the additional units and upload the form to Nova
- No additional Beacon approval is needed for increased Family Support Training only due to COVID -19 mitigation. If there are requests for any other additional services/units, please follow the normal Beacon UM process.
- The current authorization will allow for the billing of telepractice with a GT modifier code
Q: Can the Autism annual evaluations be postponed for 30 days due to the COVID-19 social distancing recommendations?
A: BHDDA has waived the prior authorization of telepractice for ABA in response to this virus. Additionally, BHDDA is expanding telehealth options and pursuing approval to waive current evaluation requirements and other barriers identified for the Medicaid ABA Benefit Program through the 1135 authority.
Q: If a family suspends services will they have to go back to network180 for a new referral?
A: No, they will be able to continue services with their current provider once services restart.
Q: Will network180 continue to pay providers at standard amounts?
A: Network180 continues to be in contact with the state regarding this and will keep providers updated as information is obtained.
BHCOE Accreditation COVID-19 FAQ’s for ABA: https://bhcoe.org/resources/covid-19-faqs-for-aba-providers
Centers for Disease Control and Prevention: https://www.cdc.gov/