When Stephanie and I began ABC Behavior in 2014, we quickly learned that Medicaid did not pay enough for us to hire technicians in the more expensive areas of the state.  We could manage well in Prince William County, but providing services in Virginia’s most populous county—Fairfax—was generally impossible.

Since 2014, Medicaid rates for ABA have remained unchanged.  But inflation has occurred and recently accelerated, particularly in the tight labor market of Northern Virginia.  The new billing structure strips out about 30% of what was previously billable, effectively requiring a net 50% increase in the new rates to maintain the present status quo in terms of services/revenue dollar.

But the status quo is not enough to save an industry already drowning in expenses…even though demand for ABA substantially exceeds the available supply of techs and BCBAs.  

The past two years we have been saved by PPP loans and CARES Act grants, but those were temporary boosts with no indication they will continue.

In order to restore economic health to the ABA industry under Virginia Medicaid, the new rates for techs should well exceed the present rate of $60/hour, and BCBA rates should compare to the $125-150/hour commonly paid by commercial insurers.  In addition, rates should be reviewed frequently to assure that inflation does not further erode the availability of good talent.  

Thank you for acting boldly to provide the funding necessary for our industry to serve Virginia families which often suffer extreme circumstances and desperately need what we offer.