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Updates to ABA Combination of Service Rules and Discontinuation of H2012
Effective date
Jan 1, 2026
Identified
Sep 29, 2026
Summary
Maryland Medicaid updates ABA billing rules effective January 1, 2026, allowing ABA services to be billed on the same date of service as behavioral health services (except Therapeutic Behavioral Services 96156/96158/96159 and Electroconvulsive Therapy 90870). Additionally, procedure code H2012 (ABA Treatment Planning) will be discontinued effective February 1, 2026, with treatment planning to be incorporated into CPT 97151 and coordination of care into CPT 97156.
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What to do
Action · 7 steps
01REQUIREMENTS:
By December 31, 2025: Billing team must update billing system configuration to allow same-day service combinations for ABA codes with behavioral health services, EXCEPT when billed with CPT 96156, 96158, 96159, or 90870.
02Update claims validation rules to permit these combinations effective January 1, 2026.
03By January 31, 2026: Billing team must verify all existing H2012 authorizations end before February 1, 2026, and ensure no new H2012 authorizations are submitted on or after that date.
04Providers must be notified that treatment planning should be documented within CPT 97151 and care coordination within CPT 97156 moving forward.
05Effective February 1, 2026: Billing system must automatically deny new authorization requests for H2012 while continuing to process authorizations for other codes in the same request.
06Ensure denial reason is documented to avoid provider confusion.
07Monitor Carelon Behavioral Health for automatic reprocessing of previously denied claims for compliant ABA/behavioral health combinations (no provider action needed, but track for claims accuracy).
If missed: Failure to implement these changes will result in claim denials for non-compliant submissions after the effective dates.
Codes mentioned
96156961589615990870H20129715197156
Original notice
Updates to ABA Combination of Service Rules and Discontinuation of H2012
health.maryland.gov · Always check the source before changing claims.
Related changes
See all Maryland Medicaid changes →PT 42-26: Updates to ABA Combination of Service Rules and Discontinuation of H2012HighEffective Jan 1, 2026 · Provider TransmittalGuidance on the Continuation of Telehealth for ABA ServicesHighEffective Nov 1, 2021 · Provider TransmittalRate Increase for Certain School-Based Services Covered Under an IEP/IFSPHighEffective Nov 1, 2021 · Provider TransmittalUpdates to ABA TelehealthHighEffective Apr 1, 2026 · ABABrowse every Maryland Medicaid change in the policy list