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Setting the facts straight on efforts to sustain and preserve Applied Behavioral Analysis (ABA) for Nebraska families.
This website was developed after misinformation was distributed to providers and the public about ABA Rate adjustments.
Please review the information below and the FAQ documents. If you have questions regarding ABA services, please don't hesitate to contact the Medicaid & Long-Term Care Division at DHHS.MedicaidMHSU@nebraska.gov.
What is Applied Behavioral Analysis or ABA?
Applied Behavior Analysis (ABA) is a critical service for many Nebraska families. It plays an essential role in helping children with autism spectrum disorder and other developmental challenges improve social interactions, learn new skills, and gain greater independence. For some families, it can be life changing.
DHHS, is committed to ensuring that children and families who rely on Medicaid continue to have access to high-quality ABA services.
Why Were Rates Adjusted?
Over the last five years, the cost of providing ABA services in Nebraska has skyrocketed. In 2020, Medicaid paid $4.6 million for ABA. Last year, that number exceeded $85 million, a more than 2,000% increase.
To ensure top level ABA services remain available to Nebraska families, Beginning August 1, DHHS will adjust ABA payment rates to align more closely with those of neighboring states. Rates remain competitive with surrounding states and continues to remain above the national average.
Rates will be adjusted as follows:
Service
| Service Description | Revised Rate |
| 97151 | Applied Behavior Analysis Behavior Identification Assessment (ABA Assessment) | $38.16 |
| 97152 | Supporting Assessments for Applied Behavior Analysis Behavior Identification Assessment (ABA Assessment), Administered by Technician, Under Supervision by a Physician or Other Healthcare Professional (per 15 minutes) | $25.88 |
| 97153 | Adaptive Behavior Treatment by Protocol Administered by Technician (per 15 minutes) | $18.70 |
| 97154 | Group Adaptive Behavior Treatment by Protocol Administered by Technician (per 15 minutes) | $7.49 |
| 97155 | Adaptive Behavior Treatment by Protocol Administered by Physician or Other Healthcare Professional (per 15 minutes) | $22.72 |
| 97156 | Family Adaptive Behavior Treatment by Protocol Administered by Physician or Other Healthcare Professional, With or Without Patient Present, With Guardian or Caregiver (per 15 minutes) | $26.06 |
| 97158 | Adaptive Behavior Treatment Social Skills Group, Administered by Physician or Other Qualified Healthcare Professional With Multiple Patients (per 15 minutes) | $12.05 |
Medicaid rates are periodically reviewed for market comparison with respect to other relative payer sources, such as Medicare and other State Medicaid Agencies. Per Code of Federal Regulations (CFR) 447.200, payments for services are expected to be consistent with efficiency, economy, and quality of care.
Nebraska Medicaid completed a rate analysis of ABA rates in regional Medicaid markets surrounding Nebraska. The rate analysis determined that Nebraska ABA rates are not aligned with CFR expectations regarding rate efficiency and economy standards.
ABA in the News
Definition and Guideline Changes
In January, DHHS Issued Guideline/Clarification Changes. To improve services for Nebraskans, it was important to develop clearer definitions and parameters related to ABA therapy. The changes include:
- Hours of service up to 30 hours per week, and direct service hours of 6 hours per day, except in cases when more hours are medically necessary.
- Lessening the requirement for Registered Behavior Technicians (RBTs). RBTs must have certification from the Behavior Analyst Certification Board and must be enrolled with Nebraska Medicaid.
- We updated the setting language in the final MSD to clarify that schools are an allowed place of service, and included guidelines for ABA services when provided in a school setting.
- A requirement of 2-4 hours per month of caregiver involvement of treatment planning
- A review and update of the treatment plan at least every 90 days.
- A goal of recovery for all individuals, regardless of diagnosis. The working definition of recovery as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) is: “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
- Increased amount of supervision required for RBTs of 10 to 20%
- Provide access to 24/7 crisis services
The Nebraska ABA MSD guidelines were developed in consultation with Doctoral Board Certified Behavior Analysts (BCBA-Ds), psychologists, psychiatrists, and physicians, who considered industry best practices, Council of Autism Service Providers (CASP) guidelines, national trends for ABA services, and the developmental appropriateness of services for the individuals being served.
DHHS received over 300 comments from ABA providers and members of the community. We want to sincerely thank all the providers who rendered their input on the draft versions of these MSDs during the open provider review and feedback period. All comments were carefully reviewed and used to inform changes and clarifications in the final service definitions.
Frequently Asked Questions