As a follow up to MassHealth’s recent announcement, we are reminding Applied Behavioral Analysis (ABA) providers that effective Jan. 1, 2025, MassHealth is implementing changes to contracting requirements, Medical Necessity Guidelines, and performance specifications for delivery of ABA services to patients with autism spectrum disorder (ASD).
Designed to enhance program integrity and increase access to services, the state’s new requirements stipulate that all contracted ABA providers must be accredited by a nationally recognized accrediting body that specializes in ABA. More specifically:
- Center-based ABAs must be accredited within two years by Jan. 1, 2027.
- All other providers must be accredited within three years by Jan. 1, 2028.
- After Jan. 1, 2028, all ABA providers (including new providers) must be accredited.
In conjunction with the state’s updated contracting requirements, changes to their ABA performance specifications and Medical Necessity Guidelines will be implemented on Jan. 1, 2025. Focused on simplifying diagnosis requirements, expanding the scope of providers who can diagnose ASD, and enhancing individualized treatment and care coordination, the new guidelines and specifications also clarify covered activities and service delivery expectations.
We’ve updated Point32Health’s Applied Behavioral Analysis performance specifications to reflect MassHealth’s Jan. 1, 2025 changes. To review both the currently effective and Jan. 1, 2025 specifications, please refer to the applicable Point32Health Behavioral Health Performance Specifications.