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Autism Care Demonstration: 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 applied behavior analysis (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 ABA services provided solely by authorized ABA supervisors defined as TRICARE-authorized Board Certified Behavior Analyst® (BCBA®), Board Certified Behavior Analyst – Doctoral® (BCBA-D®), licensed behavior analyst (LBA), or clinical psychologist.

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

  • Board Certified Assistant Behavior Analyst® (BCaBA®),
  • Qualified Autism Services Practitioner (QASP),
  • Licensed assistant behavior analyst (LABA), and/or
  • Behavior technicians (BTs), including Registered Behavior Technician® (RBT®), Applied Behavior Analysis Technician® (ABAT®), Board Certified Autism Technician (BCAT), and state-certified BTs where applicable.

Assistant behavior analysts and BTs 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 BT 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 BTs 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. 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 Versus Certification

ABA providers subject to credentialing: BCBAs, 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 (CHBC) – with county, state, federal, and sex-offender check – and current Basic Life Support (BLS)/Cardiopulmonary Resuscitation (CPR) certifications with roster submissions.
  • Use our Check Credentialing Status tool to check status online. 

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

  • ABA provider groups must submit copies of the CHBC and current BLS/CPR 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 BLS or CPR

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 recredentialing for those who do not have copies on file.

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 CHBC

HNFS must collect copies of CHBCs 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
recredentialing for those who do not have copies on file.

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

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

BTs
(Must be under the supervision of an authorized ABA supervisor)
BT certification

BTs 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

Non-network providers must submit proof of completion upon completing BLS, CPR or BT certification.  

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

 

<< Return to the main ACD page.