Maryland Medicaid (MMCP)

MedicaidMD

ABA billing requirements · Source: Maryland Medicaid — ABA Services Coverage

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth durationN/A

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceEvery 6 months

State licensure requiredBCBA state licensure required via MD Department of Health and Mental Hygiene

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsComprehensive diagnostic evaluation, Maladaptive behaviors, Skill deficits, Goals, Objectives, Specific ABA services, Frequency, Duration, Intensity, Location, Methods to measure progress, Criteria for discharge, Plan for generalization

Progress summary cadenceEvery 3 months

Policy Notes

ABA services are only available to participants under the EPSDT program and are not covered for participants 21 years old or older. The program does not cover more than 40 hours of direct ABA services per week.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Maryland Medicaid (MMCP).

Official policy source:Maryland Medicaid — ABA Services Coverage

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Data last verified: 2026-03-01 · Confidence: High · See our methodology

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