We, the Public Policy Committee of the Virginia Association for Behavior Analysis, have the following comments on the Mental Health Services Manual, Appendix D (ABA, beginning page 39).

We appreciate the clarification of supervision guidelines.

We reiterate our concerns that ABA is not in the scope of practice for any profession in Virginia outside of Licensed Behavior Analysts, Licensed Assistant Behavior Analysts, and Psychologists.  It is not a part of the scopes of practice of substance abuse counselors, clinical social workers, licensed substance abuse treatment practitioners, licensed practical nurses, marriage and family therapists, mental health professionals, professional counselors, registered nurses, registered peer recovery specialists, school psychologists, or social workers.  These providers are not permitted to provide ABA, and therefore should not be administering ABA, thus language must be clarified on this point to ensure consumers are not accidentally accessing services from professionals who are not licensed to provide it.

Our final concerns have to do with the Billing Requirements:

2. The addition to this requirement of following CPT guidelines for billing contradicts other parts of this document. For instance, the guidelines say that 97155 must be face-to-face or linked with a face-to-face appointment, but Care Coordination and often treatment planning do not meet those criteria (see #7). We believe that a separate code should be used for those services outside of 97155.  Additionally, the authorizations are all assigned to code 97155, which does not match the service actually provided and is contrary to the billing guidelines.  For specific information about ABA CPT codes, we refer you to http://abacodes.org.

9. The maximum number of caregivers for this code is 8, not 5.

11. Two technicians should not be billed under 97153, the proper code for multiple technicians is 0373T (as long as all four of the code elements are met). Billing two at the same time using 97153 would either receive a denial, or it would adversely affect the total number of hours allocated in the authorization.

13. (assumed, as the number is missing). This references the telehealth manual, however, our codes have been excluded in the changes. Additionally, we believe that MCOs should follow DMAS’s guidelines rather than creating their own.

We thank you for the opportunity to comment and welcome your continued partnership.