How to start an ABA practice in Maryland

Maryland requires a Licensed Behavior Analyst (LBA) from Maryland Board of Professional Counselors and Therapists (Maryland Department of Health), with a Behavior Analyst Advisory Committee to operate an ABA practice. Fee: $200.

License required

Yes

License

Licensed Behavior Analyst (LBA)

Issuing agency

Maryland Board of Professional Counselors and Therapists (Maryland Department of Health), with a Behavior Analyst Advisory Committee

Fee

$200

Fee details

$200 nonrefundable application fee, plus a $150 license fee once approved.

Renewal

Every 2 years · Renew every two years with current BCBA/BCBA-D certification verified with the BACB. Renewal fee amount not stated on the application (set in COMAR 10.58.02).

Professional license

board: Maryland Board of Professional Counselors and Therapists (Behavior Analyst Advisory Committee, COMAR 10.58.16); statute: Md. Health Occupations Art., Title 17 (behavior analysts); COMAR 10.58.16; fees COMAR 10.58.02; behavior analyst: LBA requires current BCBA/BCBA-D certification, a master's degree or higher, and a criminal history records check.; assistant behavior analyst: No separate Maryland assistant license was found. BCaBAs work under supervision and enroll with Medicaid as rendering providers.; technician: No state technician license. For Medicaid, RBTs and Behavior Technicians must enroll individually in ePREP. A BT may enroll before RBT certification but must submit proof of RBT certification within a 90-day grace period that follows the individual.; medicaid enrollment: Maryland Medicaid ABA (EPSDT), administered by Carelon Behavioral Health as the BHASO under COMAR 10.09.28. ABA groups and individual psychologists, BCBA-Ds, BCBAs, BCaBAs, RBTs and BTs all enroll through ePREP and then register with the ASO. Only groups and individual psychologists, BCBA-Ds and BCBAs may bill. A CJIS criminal background check is required at enrollment.

Regulation

COMAR 10.58.16; COMAR 10.58.02; COMAR 10.09.28 (Medicaid ABA)

1. Hold current BCBA or BCBA-D certification and a master's degree or higher at the time of certification
2. Obtain a criminal history records check (CHRC) before applying
3. Submit the notarized application with photo and the $200 fee
4. Pay the $150 license fee when approved
5. Renew every two years

Staffing

• Medicaid: BCaBA, RBT and BT services must be performed under the direction of a psychologist, BCBA-D or BCBA

Program

Maryland Medicaid (Maryland Medical Assistance Program, Maryland Department of Health) — HealthChoice

Enrollment portal

Maryland Provider Registration and Information Management Enterprise (MPRIME), replacing ePREP in October 2026

Application fee

Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

To prepare for MPRIME, Maryland moved revalidations due May-October 2026 earlier (notices February-April 2026, 90 days to finish) and put new or updated applications on hold from July 1 (moderate/high risk) and August 1 (limited risk) until the October 2026 go-live. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Maryland Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Maryland Health Care Commission (MHCC)

Services covered

• hospitals and limited service hospitals
• related institutions (including comprehensive care facilities / nursing homes)
• ambulatory surgical facilities
• inpatient rehabilitation facilities
• home health agencies
• hospices
• freestanding medical facilities
• new facilities, relocations, bed capacity changes, changes in type or scope of service, and capital expenditures above the statutory threshold

Maryland certificate of need details →

State minimum wage

$15.00 an hour

Effective

2024-01-01

Scheduled increases

No scheduled change found in the official sources reviewed.

Rate pass-through

Maryland law lets part of the mandated DDA community provider rate increase be allocated to cover the effect of state minimum wage increases on direct support worker wages and benefits; it is permissive, not a required share.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Applied behavior analysis organizations — active organization NPIs (NPPES)

567 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,385,888 (as of Jun 1, 2026)

All Maryland ABA Medicaid rates, ranked →

• 1915(i) Home and Community-Based Behavioral Health Services for Children, Youth and Families (1915(i))
• Waiver for Children with Autism Spectrum Disorder (1915(c))
• Brain Injury Waiver (1915(c))
• Community Pathways Waiver (1915(c))
• Medical Day Care Services Waiver (1915(c))
• Model Waiver for Fragile Children (1915(c))
• Home and Community Based Options Waiver (1915(c))

Maryland waivers and waiting lists →