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DPW Requires BS Licenses for Autism Services
August 17, 2012

The Department of Public Welfare (DPW) Bureau of Autism Services and the Bureau of Children’s Behavioral Health Services have issued a letter stating that individuals working with children with autism to “design, implement or evaluate a behavior modification plan who desire to bill for the services should plan on becoming a licensed Behavior Specialist.”  It states all behavior specialists, including behavior specialist consultants who intend to continue to work with children with autism should plan to obtain licensure prior to May 26, 2013.

PCPA and its members have understtod that the behavior specialist license was intended to enable individuals to be credentialed by commercial insurance plans and to enroll in the state Medicaid program provider as an individual service provider.

PCPA did not interpret Act 62 as intending to create a new and unprecedented standard for autism services delivered under a psychiatric outpatient clinic, partial hospital, or other program operated under an agency’s mental health program license and provider billing number. The Medicaid mental health program does not require an individual professional license and provider number for staff (other than physicians) providing services within a licensed agency. The Medicaid psychiatrically-supervised system of care (clinic model) has never required individuals to hold a license as a clinical social worker, professional counselor, marriage and family therapist, etc. unless practicing and billing as an individual and independent practitioner.

The interpretation of the Autism Insurance Act implied by this notice from DPW is not consistent with the state Medicaid plan for mental health services and may significantly impact access to care, cost, and the availability of behavioral specialist consultants required to meet service needs of children on the autism spectrum.

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