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Applied Behavior Analysis Provider Types and Requirements

Overview

Education and certification requirements to become a provider for the Autism Care Demonstration (ACD) are outlined in the TRICARE Operations Manual, Chapter 18. 

Visit our Become a TRICARE Provider or ABA provider frequently asked questions page to learn more about becoming a TRICARE network or non-network provider, adding providers to your group and the credentialing process. 

Provider Types

Under the ACD, TRICARE beneficiaries receive applied behavior analysis (ABA) services provided solely by authorized ABA supervisors defined as TRICARE-authorized Board Certified Behavior Analysts® (BCBAs), BCBA-doctoral (BCBA-Ds), licensed behavior analyst (LBA) or clinical psychologists.

Under the tiered-delivery model, the authorized ABA supervisor receives support from:

  • Board Certified Assistant Behavior Analysts® (BCaBAs),
  • Qualified Autism Services Practitioners (QASPs),
  • licensed assistant behavior analyst (LABA) and/or
  • behavior technicians, including Registered Behavior Technicians™ (RBTs), ABA Technicians (ABATs) and Board Certified Autism Technicians (BCATs) and state certified behavior technicians where applicable.

Assistant behavior analysts and behavior technicians work one-on-one with the beneficiary to implement the treatment plan designed, monitored and supervised by the authorized ABA supervisor.

An assistant behavior analyst and/or behavior technician working within the scope of his or her training may assist the authorized ABA supervisor in various roles and responsibilities as determined appropriate by the TRICARE Operations Manual and the authorized ABA supervisor with an ABA scope of practice. Assistant behavior analysts and behavior technicians must work under the supervision of an authorized ABA supervisor.

Note: Supervisors providing ABA services in a state that has a behavior analyst state license or certification must be licensed or certified in that state. Board Certified Assistant Behavior Analysts® (BCaBAs) providing ABA services in a state that offers an assistant behavior analyst license or certification must be licensed or certified in that state.
 

Credentialing vs. Certification

ABA providers subject to credentialing: BCBAs, BCBA-doctoral BCBA-Ds, LBAs, BCaBAs, QASPs and LABAs. It can take HNFS up to 60 days from the receipt of a complete packet to credential a network ABA provider (BCBA, BCBA-D, BCaBA, QASP or LBA) based upon the accuracy of the information provided.

  • Please include copies of the criminal history background check (with county, state, federal, and sex offender check) and current CPR/BLS certifications with roster submissions.
  • Use our Check Credentialing Status tool to check status online. 

ABA providers subject to certification: Behavior technicians (BTs) are subject to a certification process in order to participate as an ACD provider.

  • ABA provider groups must submit copies of the criminal history background check and current CPR/BLS documentation with their roster submission when adding BTs to be certified. 
  • BT certification takes up to 10 days from the receipt of a complete request.

Provider Requirements

Please see our ACD Provider Roster page for instructions to network providers on submitting required documentation to HNFS. 

 

Provider Type Certification Requirement
All ABA Providers Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR) Certification

HNFS must collect copies of BLS/CPR certification from all ABA providers. 

All ABA providers must complete BLS or CPR-equivalent certification as demonstrated by completion of a 100% in-person or hybrid course of a web-based instruction component and live component to demonstrate skills on a dummy.

ABA supervisors and assistant behavior analysts: HNFS will collect copies with roster submissions when adding new providers and during the re-credentialing for those who do not have copies on file.

Behavior technicians (BTs): HNFS will collect copies with roster submissions when adding new BTs or during recertification for those who do not have copies on file.  

Non-network providers must submit proof of completion of BLS or CPR certification. (See "Proof of Certification ..." section below.)

All ABA Providers Criminal History Background Check

HNFS must collect copies of criminal history background checks from all ABA providers. CHBCs must include current federal, state, and county criminal and sex offender reports for all locations resided or worked in during the previous 10 years.

ABA supervisors and assistant behavior analysts: HNFS will collect copies with roster submissions when adding new providers or during the re-credentialing for those who do not have copies on file.

Behavior technicians (BTs): HNFS will collect copies with roster submissions for new BTs or during recertification for those who do not have copies on file.  

Sole providers: HNFS will run the background checks for all sole providers. 

All ABA Providers National Provider Identifier (NPI)

All ABA providers must have a National Provider Identifier (NPI). 

Verify your NPI record is up to date by visiting https://npiregistry.cms.hhs.gov.

Behavior Technicians
(must be under the supervision of an authorized ABA supervisor)
Behavior Technician Certification

Behavior technicians must be certified by one of the following in order to provide services as a TRICARE-authorized provider:

Non-network providers should send proof of certification such as the certificate number or registration number from one of the agencies identified above. (See "Proof of Certification ..." section below.)

Proof of Certification Requirements for Non-Network Providers

Upon completion of BLS, CPR or BT certification, non-network providers must submit proof of completion.  

Fax or mail a completed ACD BLS/CPR Requirement Form - Non-Network Providers to PGBA, LLC:

  • Fax: 1-844-730-1373
  • Mail: TRICARE West – Provider Data Management
    PO Box 202106
    Florence, SC 29502-2106

 

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