Provider Notice issued 0824/2023

Pursuant to Public Act 103-0102, this notice informs providers of updates to the requirements for participation as a provider of Adaptive Behavior Support (ABS) services. Specifically, this update:

1.    Removes the requirement for unlicensed ABS Clinicians and ABS Technicians to receive clinical supervision from a licensed practitioner of the healing arts (LPHA);

2.    Eliminates all requirements for written collaborative agreements between enrolled ABS providers; and,

3.    Expands the pool of providers eligible to enroll for the provision and reimbursement of ABS services.

The information in this notice supersedes any prior information notices detailing ABS provider enrollment requirements.

Provider Types Eligible for Reimbursement

Effective with dates of service on and after February 1, 2022, ABS services rendered by an ABS Clinician or an ABS Technician, as defined herein, are reimbursable to enrolled Behavioral Health Clinics (BHCs) and independently enrolled ABS Clinicians.

Independently enrolled ABS Clinicians may bill only for services the ABS Clinician personally provides or that are provided, under the ABS Clinician's supervision, by an ABS Technician with whom the ABS Clinician has an established employment, contractual, or similar relationship.

All individuals rendering covered ABS services to Illinois Medical Assistance Program customers must be enrolled in the IMPACT system, including those individuals employed by and rendering services under the auspices of an enrolled BHC.

ABS Clinicians

An ABS Clinician is defined as an individual providing professional services and enrolled independently or providing services as an employee of a BHC and who meets the qualifications of a Board-Certified Behavior Analysts (BCBA) or an ABS Developmental Clinician.

         ·BCBA. BCBAs certified and in good standing with the Behavior Analyst Certification Board (BACB) may enroll in IMPACT to render and receive reimbursement for ABS services, selecting the appropriate Provider Type/Specialty/Subspecialty combinations based upon the provider’s credentials. BCBAs who are also licensed pursuant to a state practice act (i.e., licensed clinical psychologists, licensed clinical social workers, licensed clinical professional counselors, licensed marriage and family therapists, occupational therapists, and speech-language pathologists) must enroll as the Provider Type and Specialty corresponding to their licensure, and then must select ‘Board Certified Behavior Analyst’ as their Subspecialty. 

        ·ABS Developmental Clinician. Any of the following practitioners licensed within the state of practice and who have advanced training in developmental interventions may enroll in IMPACT to render and receive reimbursement for ABS services, selecting the appropriate Provider Type and Specialty corresponding to their licensure, and then selecting ‘ABS Developmental Clinician’ as their Subspecialty:

     o  A Licensed Clinical Psychologist (LCP); or

     o  A Licensed Clinical Social Worker (LCSW); or

     o  A Licensed Clinical Professional Counselor (LCPC); or

     o  A Licensed Marriage and Family Therapist (LMFT); or

     o  A licensed Occupational Therapist; or

     o  A licensed Speech-Language Pathologist.

To enroll as an ABS Developmental Clinician, practitioners must demonstrate proof of any one of the certifications listed in Table 1 below.

Table 1. ABS Developmental Clinician Approved Certifications

ABS Technicians

An ABS Technician is defined as an individual delivering services under the supervision of an ABS Clinician and who meets the qualifications of a Registered Behavior Technician (RBT) or an ABS Developmental Technician.

·  RBT. RBTs certified and in good standing with the BACB may enroll in IMPACT to render ABS services, selecting the Provider Type/Specialty combination of Adaptive Behavior Supports/ABS Registered Behavior Technician. RBTs must receive supervision from a BCBA.

· ABS Developmental Technician. Individuals who meet all the following qualifications may enroll in IMPACT as an ABS Developmental Technician by selecting the Provider Type/Specialty combination of Adaptive Behavior Supports/ABS Developmental Technician:

    o  Age 18 or older;

    o  Has a high school diploma/GED; and,

    o  Credentialled as a Profectum Registered Developmental Technician (PRDT).

ABS Developmental Technicians must receive supervision from an ABS Developmental Clinician.

Table 2 below provides a crosswalk to assist providers of ABS services in the IMPACT enrollment process.

Table 2: IMPACT Enrollment Guide for ABS Services

Questions regarding this notice may be directed as follows:

• ABS policy and general ABS questions: omi.support@uillinois.edu

• Behavioral Health and ABS IMPACT enrollment: omi.impact@uillinois.edu

Kelly Cunningham, Administrator
Division of Medical Programs