Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XV - Services for Special Populations
Subpart 1 - Applied Behavior Analysis-Based Therapy Services
Chapter 7 - Reimbursements
Section XV-703 - Reimbursement Methodology
Universal Citation: LA Admin Code XV-703
Current through Register Vol. 50, No. 9, September 20, 2024
A. Reimbursement for ABA-based therapy services shall be based upon a percentage of the commercial rates for ABA-based therapy services in the state of Louisiana.
B. Effective for dates of service on or after January 1, 2017, ABA rates and codes in effect on December 31, 2016 may be realigned to be consistent with Louisiana commercial rates or ABA codes adopted by the American Medical Association via current procedural terminology (CPT) codes.
1. Prior
authorizations already in effect on the promulgation date of these provisions
will be honored. Those services shall be paid at the rate in effect on December
31, 2016.
2. New prior
authorizations with a begin date after the promulgation date of these
provisions must use the codes in effect prior to January 1, 2017 for those
services provided and to be delivered prior to January 1, 2017, and for any
services provided after January 1, 2017, the codes in effect at the time of
service delivery.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
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