MedicaidCoverageHigh impact
PT 60-26: Updates to ABA Telehealth
Maryland Medicaid·MD · Physical Therapy, Occupational Therapy·Telehealth
Effective date
Apr 1, 2026
We identified it
Jun 18, 2026
Summary
Starting April 1, 2026, ABA telehealth services for supervision and parent training must include at least 25% in-person delivery, with only 75% allowed via telehealth. Providers must use GT modifier when billing for telehealth portions of these services.
Action Required
By April 1, 2026: Billing team must update service delivery protocols to ensure CPT codes 97155, 97156, and 97157 include minimum 25% in-person services. Update billing system to require GT modifier for telehealth portions. Train clinical staff on new delivery requirements. Claims not meeting the 25% in-person requirement may be denied.