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PT 42-26: Updates to ABA Combination of Service Rules and Discontinuation of H2012

Maryland Medicaid·MD · Psychiatry·Provider Transmittal
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Days to comply

Summary

Maryland Medicaid is updating ABA service billing rules effective January 1, 2026 to allow combination billing with most behavioral health services (except codes 96156, 96158, 96159, and 90870), and discontinuing procedure code H2012 effective February 1, 2026 with functions moved to codes 97151 and 97156.

Action Required

Action needed
By January 1, 2026: Billing team must update system to allow ABA services to be billed same-day with behavioral health services except codes 96156, 96158, 96159, and 90870. By February 1, 2026: Stop using H2012 for ABA treatment planning and transition to using 97151 for treatment planning and 97156 for coordination of care. Update billing software to block H2012 authorization requests after January 31, 2026. Existing H2012 authorizations remain valid through their end dates.

Affected Billing Codes

96156
96158
96159
90870
H2012
97151
97156