Applied Behavior Analysis Maximum Allowed Amounts

ABA Maximum Allowed Rates Effective May 1 2019

ABA Maximum Allowed Amounts Effective May 1, 2018

Applied Behavior Analysis Maximum Allowed Amounts - Effective May, 1, 2017

Higher of Original ACD Rates--$125/$75/$50, December 23, 2016 Posted Rates, or Updated 2017 Locality Rates

Applied Behavior Analysis Maximum Allowed Amounts - Spring 2016

These rates were calculated by updating the National Rates presented at the ABA Roundtable (Dec 3, 2015) based on a re-survey of the states' Medicaid rates in January and February 2016. The updated National Rates were then adjusted using the Medicare geographic locality factors, exactly as used to adjust all other TRICARE rates. The rates depicted are either the actual rate calculated or the current rate less 15%, whichever is higher. The rates have also been adjusted to ensure that they are no less than the Medicaid rates in those states which have adopted statewide Medicaid rates for these services. The rates are effective April 1, 2016, for the localities below numbered 301-389. The rates without a locality number at the bottom are effective May 1, 2016.

RAND Report: TRICARE Applied Behavior Analysis Benefit

This report, prepared by the RAND Corporation, provides a comparison of TRICARE's current applied behavior analysis benefit with Medicaid and commercial benefits. The comparison includes reimbursement rates, copayments and annual caps.