Telehealth and telesupervision for ABA in Montana

Yes.

Behavior Analyst / Assistant Behavior Analyst license

Montana Board of Psychologists

We could not verify this yet - check with Montana Board of Psychologists.

BACB's state licensure table lists Montana as licensing behavior analysts (since 2017) through the MT Board of Psychologists; the board's page lists a 'Behavior Analyst and Assistant Behavior Analyst' license section, but I did not open the requirements, statute, or fees. Apply via ebiz.mt.gov/pol.

We could not verify this yet - check with the state Medicaid agency or licensing board.

Licensure: MCA 37-2-305 (Ch. 497, L. 2021) allows a person licensed under Title 37 to use telehealth, including audio-only, over a secure connection that meets state and federal privacy law, if it is appropriate, meets the standard of care, and complies with board rules. Fax or electronic messaging alone is not telehealth. ARM 24.189.424 (NEW, 2023 MAR p. 1749, effective 12/9/2023; Cornell LII, medium) says Board of Psychologists licensees, including behavior analysts, may provide telehealth as provided in that statute. The licensee-patient relationship may be established by telehealth if the standard of care does not require an in-person meeting (ARM 24.189.301 defines that relationship as existing whether or not there has been an in-person meeting). Behavior technicians are not licensed. Under MCA 37-17-405 they, and assistant behavior analysts, must be supervised by a behavior analyst licensed under that part or by a licensed psychologist who is ABPP-certified in behavioral and cognitive psychology. Medicaid: ARM 37.34.1918(2)(f) requires ABA to be delivered with the provider and the member in the same physical location unless the department authorizes otherwise in writing. The rule was new effective 9/24/2022 (2022 MAR p. 1850) and was amended by MAR Notice No. 2025-276, effective 10/11/2025; the in-person clause remains. The March 21, 2023 DDP provider notice and the April 10, 2023 all-provider notice (both effective May 12, 2023) kept ABA telehealth after the COVID-19 public health emergency ended on May 11, 2023: face-to-face is preferred, telehealth may be used if clinically appropriate, and the Telehealth Exception Request must be approved first. The form (medicaidprovider.mt.gov, file name dated 09/22/2022) is an initial or renewal prior authorization. It requires the reason telehealth is medically necessary, patient characteristics that support it, treatment-plan goals not suitable for telehealth, how effectiveness will be monitored and at what intervals, and an environmental safety assessment of the treatment setting. Practitioners must follow Council of Autism Service Providers (2021), Practice Parameters for Telehealth-Implementation of Applied Behavior Analysis, Second Edition. Submit to ddpservicerequest@mt.gov via the Montana State File Transfer Service. DPHHS accepts or declines. The ABA Services Manual lists that form as required when requesting telehealth (added to the forms list 09/23/2022) and does not state an hour, unit, or percentage cap. Medicaid eligibility on the DPHHS ABA page: ASD, member no older than 20; SED, no older than 17, or no older than 20 if enrolled in an accredited secondary school, plus functional-impairment criteria; state developmental-disabilities eligibility, no older than 20, plus functional-impairment criteria. Services must be directed by a BCBA or BCBA-D. A BCaBA or RBT who meets ARM 37.34.1930 may provide some services if supervised under MCA 37-17-403 and 37-17-405 (ARM 37.34.1918(2)(b), as amended 10/11/2025). When Medicaid telehealth is allowed, MCA 53-6-122(3)(c) and the March 21, 2023 Coverage and Reimbursement Policy notice require the same payment rate as in-person care. Modalities in that general notice include secure portal messaging, secure instant messaging, telephone, and audiovisual. An enrollee's home is not payable as an enrolled originating site (MCA 53-6-122(4)). Claims must use the appropriate CPT or HCPCS code, place of service, and modifier. The general notice does not name an ABA-specific modifier. Commercial autism coverage is separate: MCA 33-22-515 requires group disability policies to cover diagnosis and treatment of autism spectrum disorders, including applied behavior analysis, for a covered child 18 or younger. Coverage may be limited to $50,000 a year for a child 8 or younger and $20,000 a year for a child 9 through 18. ABA under that section must be provided by an individual who is licensed by the Behavior Analyst Certification Board or certified by DPHHS as a family support specialist with an autism endorsement. The section does not mention telehealth.

MCA 33-22-138 (Montana Code Annotated 2025; enacted Ch. 164, L. 2013; amended through Ch. 8, L. 2025). Each group or individual disability policy, certificate, subscriber contract, membership contract, or health care services agreement that covers a service must cover it when a health care provider or health care facility delivers it by telehealth. Coverage must be equivalent to in-person coverage. The plan may not restrict the site where the patient or the provider is located and may not distinguish rural from urban telehealth. Deductibles, coinsurance, copayments, or other limitations on telehealth may not exceed those applicable to other medical services covered under the plan. The section does not require coverage of a noncovered benefit or of care that is not medically necessary, and it does not state a same-dollar commercial fee. It does not apply to disability income, hospital indemnity, Medicare supplement, specified-disease, or long-term care policies. 'Health care provider' includes an individual licensed under Title 37, chapter 17, the chapter that licenses behavior analysts and assistant behavior analysts. It does not name unlicensed behavior technicians. Telehealth in this section includes audio, video, or other telecommunications, including audio-only, over a secure connection. Medicaid same-rate payment is MCA 53-6-122(3)(c), not 33-22-138.

For Montana Medicaid ABA, ARM 37.34.1918(2)(f) requires the service to be provided to the member in person, provider and member in the same physical location, unless DPHHS specifically authorizes otherwise in writing. The April 10, 2023 notice (effective May 12, 2023) states face-to-face delivery is preferred and that the Telehealth Exception Request must be approved before telehealth delivery. No rule or manual section opened here sets a maximum share of hours, a required first in-person visit, or a required in-person ratio for Medicaid ABA. For licensed practice, ARM 24.189.424 requires an in-person interview and examination only when the standard of care requires it. MCA 33-22-138(4)(c) does not require a commercial telehealth provider to be physically present with the patient unless the provider making the telehealth determination decides that presence is necessary.

ARM 24.189.950 (NEW, 2023 MAR p. 1749, effective 12/9/2023; Cornell LII, medium) requires the supervisor of an assistant behavior analyst or behavior technician to meet face-to-face at least once a month for discussion, education, training, practice issues, and client care, and to have a written agreement covering supervision methods, scope and limits of delegation, and the frequency and duration of face-to-face meetings. Supervisees must be reported to the board within five business days. Agreements are kept seven years. A behavior analyst may supervise up to three student interns if also supervising behavior technicians or assistant behavior analysts, or up to seven student interns if not. The rule does not cap the number of behavior technicians and does not set a percentage of RBT hours. ARM 24.189.301 does not define face-to-face. MAR Notice No. 24-189-44 (10/20/2023 proposal, whose NEW RULE VIII text matches the adopted rule) said the board was eliminating the list of allowable supervision types because there is no longer a prohibited method and the licensee supervises according to accepted standards of practice. That notice does not say the monthly face-to-face meeting may be video. MCA 37-17-405 requires supervision but does not address modality. Medicaid member-facing ABA by an RBT remains subject to the in-person rule in ARM 37.34.1918(2)(f) unless DPHHS authorizes telehealth in writing. No opened Medicaid ABA rule states whether remote observation of an in-person RBT session needs that exception.