Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autistic Disorder: Enrollment for New Provider Specialty: Board Certified Behavioral Analyst (BCBA), CR 29135

February 11, 2014

Enrollment is open for the Board Certified Behavioral Analyst (BCBA) provider specialty under MaineCare Benefits Manual Section 21. Behavioral Consultation Services (billing code G9007 HI) is now a covered service when provided by a BCBA. These services must be prior authorized by the Office of Aging and Disability Services (OADS).

If you would like to enroll as a BCBA, you must first submit your request to enroll to OADS, including the following information:

  1. A brief description of the BCBA service you will provide and your catchment area.
  2. A list of providers of the direct BCBA service.
  3. A copy of the current Behavioral Analyst Certificate for BCBA service provider

Please submit your request to the attention of the Resource Coordinator at the following address:

DHHS OADS Developmental Services Attn: Resource Coordinator 161 Marginal Way Portland, ME 04101

An OADS Resource Coordinator will confirm the required information has been received. Once you receive the confirmation, please visit the MIHMS Health PAS Online Portal at this location https://mainecare.maine.gov/ProviderHomePage.aspx and follow the instructions below:

  1. New Enrollments: a. Click on the In-State Provider Enrollment link in the left menu. b. Enroll a service location and name it “Agency Name-BCBA” using its physical location street address. c. Follow the instructions on the portal and choose the Provider Type 73-Waiver Services Provider when prompted. d. Choose the Specialty 167 - Board Certified Behavior Analyst (BCBA) from the drop-down list. e. Complete and submit your enrollment following the instructions on the portal.

  2. Previously Enrolled Providers:
    a. Log in to your Trading Partner Account and click on Provider Maintenance Full link. b. Add a new location and name it “Agency Name-BCBA” using its physical location street address. c. Follow the instructions on the portal and choose the Provider Type 73-Waiver Services Provider when prompted. d. Choose the Specialty 167 -Board Certified Behavior Analyst (BCBA) from the drop-down list. e. Complete and submit your enrollment following the instructions on the portal.

You will receive notification when this location is approved to provide the BCBA Specialty. Prior authorizations can be created for Behavioral Consultation Services after you have successfully enrolled a service location with the BCBA Specialty.

You must first submit a “Service Proposal Form” to the member’s Case Manager. You will receive notification from the Resource Coordinator if your request has been authorized. If approved, you will be able to provide these prior-authorized services and submit your claims for those services.

You may contact your local OADS Resource Coordinator with questions or for further assistance.