[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-316476-105":59,"doc-detail-316476-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","aba-provider-meeting-rate-methodology-draft-rates","ABA Provider Meeting-Rate Methodology - Draft Rates","","Applied Behavioral Analysis (ABA) therapy reimbursement review prepared for the Indiana Family and Social Services Administration’s Office of Medicaid Policy and Planning. It outlines strategic objectives for rate setting aligned with CMS requirements, focusing on continuity, sustainability, person-centered value-based purchasing, and disparity reduction. The review compares current reimbursement to HCBS and waiver programs, highlights misalignment using code 97153, and presents provider survey data, cost-per-unit calculations, assumptions, and proposed ABA therapy rates with a timeline.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/aba-provider-meeting-rate-methodology-draft-rates/316476/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/aba-provider-meeting-rate-methodology-draft-rates/316476.png","ImageObject",300,407,{"name":92,"@type":93},"Seraphina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What strategic objectives guide Indiana’s ABA rate-setting methodology?","Question",{"text":112,"@type":113},"The methodology targets alignment across rate methods, sustainability for adequate access to quality services, person-centeredness and value-based purchasing, and reduction of disparities in access and quality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does current ABA reimbursement misalign with other programs?",{"text":117,"@type":113},"The review notes lack of alignment using code 97153, where average managed care paid claims are $91/hour and rates vary widely across locations, contributing to inconsistent payment outcomes.",{"name":119,"@type":110,"acceptedAnswer":120},"What cost and wage assumptions are used in the provider survey data analysis?",{"text":121,"@type":113},"The model uses a 7.5% annual wage inflation assumption applied from the midpoint of the provider fiscal year to the midpoint of the rate implementation period, and it includes direct care staffing salaries, overhead, and identification of non-allowable costs.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},316476,1790059043,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962075114101,"https://ap-avatar.wpscdn.com/avatar/e000253a75eb197efd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780044092746381165","Applied Behavioral Analysis (ABA) Therapy Services  \nReimbursement Review  \nABA Provider Meeting-Rate Methodology /Draft Rates  \nIndiana Family and Social Services Administration  \nOffice of Medicaid Policy and Planning  \n1August 8, 2023  \nABA Therapy Provider Reimbursement  \n• Objectives / Environment  \n• ABA Provider Survey Data  \n• Rating Methodology / Assumptions  \n• Proposed ABA Therapy Rates  \n• Timeline  \nFSSA Strategic Objectives for Rate Setting  \nTo develop rate setting methods that comply with Centers for Medicare and Medicaid Services (CMS) rules and achieve the following:  \n• Alignment-Bring continuity and alignment across rate methodologies, providing a consistent framework and supporting payment rates that advance FSSA goals .  \n• Sustainability-Facilitate adequate participant access to quality services, as required by CMS. Cost effective, provide for long-term workforce growth and provider stability, and affordable by the State . Reduce administrative burden. Ensure predictability.  \n• Promote Person-Centeredness and Value-Based Purchasing-Striving to align provider and participant incentives to achieve access to person-centered services, encourage services that drive healthy outcomes and participant satisfaction .  \n• Reduce Disparities – Analyze and quantify disparities in access, quality, site of care, and person-centeredness, then build payment structures to level the playing field.  \nReimbursement Currently Lacks Alignment Code 97153 – Average Managed Care Paid Claim = $91/hour  \n• Bars shown in chart represent average paid claims for each of the  \n199 locations that billed MCEs for 3Q 2022  \n• Paid hourly rates averaged $91 and ranged from $46 to $222  \n• Implementation of a Minimum Fee Schedule will increase rate alignment across ABA providers  \n4  \nABA Reimbursement vs . Waiver Rates ABA Spend does not align with other State Programs  \n$100.00  \n$90.00  \n$80.00  \n$70.00  \n$60.00  \n$50.00  \n$40.00  \n$30.00  \n$20.00  \n$10.00  \n$0.00  \nHCBS Rate Comparison  \n• Current HCBS rates include a load of 98%  \n-135% of base direct care wage to cover supervision, program costs, admin costs, etc.  \n• Current ABA reimbursement represents load of 310% for comparable cost categories  \nParticipant Assistance and Care  \nResidential Habilitation Services  \nABA Services (97153) Respite LPN Behavior Management  \n(MS degree)  \nRespite RN  \n Direct Care Wages  All Other Costs  \nApplied Behavioral Analysis (ABA) Therapy Services Indiana Medicaid Expenditure Growth Rate of 50%+  \n• ABA Services are primarily provided through Waiver programs (FFS) and Hoosier Care Connect (Managed Care)  \n• Rate of expenditures increases presents sustainability challenge  \nABA Reimbursement  \nComparison of Medicaid Reimbursement by State  \n\n| $140.00\u003Cbr>$120.00\u003Cbr>$100.00\u003Cbr>$80.00\u003Cbr>$60.00\u003Cbr>$40.00\u003Cbr>$20.00\u003Cbr>$ - | Hourly Reimbursement Rates Code 97153\u003Cbr>Median Hourly Rate of $60.00 \u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>|  |\n| --- | --- | --- |\n| |  | |\n\n Other States  \n Indiana  \nABA Provider Survey Data  \nClarification of Summary Data Slide Wage Inflation Assumption Program Costs  \nNon-Allowable Costs  \nABA Provider Survey Data Calculation of Average Cost per 15 Minute Unit  \nCost / Utilization data shown is for all services / codes  \n\n| Total Units of Service | 13,516,663 |\n| --- | --- |\n\nDirect Care Staff Salaries  \nAverage for all staff is $39.92 / hr. Average for RBT is $20.79 / hr.  \n\n| Cost Description | Total Costs | Cost per 15 Minute Unit |\n| --- | --- | --- |\n| Direct Care Staff Salaries and Fringe Benefits | $ 134,890,221 | $ 9.98 |\n| Other Direct Care Expenses (Non-Staff) | $ 12,071,616 | $ 0.89 |\n| Administrative and Facility Overhead | $ 83,237,291 | $ 6.16 |\n| Non-allowable Costs | $ 33,068,527 | $ 2.45 |\n| Total Costs | $ 263,267,655 | $ 19.48 |\n\n\n| Total Costs Excluding Non-allowable Costs | $ 230,199,128 $ 17.03 |\n| --- | --- |\n\nAdmin / Facility Overh","cbCaiojEUdNnyrOe","https://ap.wps.com/l/cbCaiojEUdNnyrOe","pdf",832283,26,"English","# FSSA Strategic Objectives for Rate Setting\n## Alignment, Sustainability, and Value-Based Purchasing\n## Reduce Disparities and Ensure Predictability\n# Reimbursement Currently Lacks Alignment\n## Code 97153 Average Paid Claim and Location Coverage\n# ABA Reimbursement vs. Waiver Rates\n## HCBS Rate Comparison and Load Assumptions\n# ABA Provider Survey Data\n## Wage Inflation Assumption and Non-Allowable Costs\n## Cost per 15 Minute Unit Calculation","[{\"question\":\"What strategic objectives guide Indiana’s ABA rate-setting methodology?\",\"answer\":\"The methodology targets alignment across rate methods, sustainability for adequate access to quality services, person-centeredness and value-based purchasing, and reduction of disparities in access and quality.\"},{\"question\":\"How does current ABA reimbursement misalign with other programs?\",\"answer\":\"The review notes lack of alignment using code 97153, where average managed care paid claims are $91/hour and rates vary widely across locations, contributing to inconsistent payment outcomes.\"},{\"question\":\"What cost and wage assumptions are used in the provider survey data analysis?\",\"answer\":\"The model uses a 7.5% annual wage inflation assumption applied from the midpoint of the provider fiscal year to the midpoint of the rate implementation period, and it includes direct care staffing salaries, overhead, and identification of non-allowable costs.\"}]","ABA Provider Meeting-Rate Methodology - Draft Rates | PDF",1789917535,66]