Telehealth and telesupervision for ABA in Washington

Yes.

Licensed Behavior Analyst (LBA); Licensed Assistant Behavior Analyst (LABA)

Washington State Department of Health (DOH)

RCW 18.380; WAC 246-805

RCW 18.380: no person may practice ABA without a license or temporary license (certain exemptions). LBA by current equivalent certification from a credentialing entity, or by master's/doctorate, 225 classroom hours, supervised experience and national exam (WAC 246-805-100). Fees per WAC 246-805-990: LBA initial $250, renewal $350; LABA initial $160, renewal $175; CBT initial $95, renewal $150; renewal every two years on birthday.

Sometimes. See the detail below.

As of 2026-10-21, WAC 182-531A-1200 says ABA services delivered using telemedicine may be reimbursed by the agency, so coverage is conditional on procedure code and service type. HCA has added CPT 97156 to the list of procedure codes allowed using telemedicine. The July 2025 HCA billing guide was cited for the code-level table, but an independent check could not read it. These code-level details are therefore unverified and should be confirmed against the current HCA billing guide before use: telemedicine allowances for 99366, 99368, 97155 and 97157; limiting 97151 assessment to indirect activities (with direct observation and direct assessment excluded); and the list of codes not paid via telemedicine (0362T, 0373T, 97153, 97154, 97158). Direct technician treatment (97153) is supported as an in-person service by the on-site rule below.

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

Direct services by a certified behavior technician (CBT), including technician treatment billed as 97153, must be provided on site (WAC 182-531A-0700: 'Provide direct on-site services'). In day treatment programs, a minimum of 2 caregiver training sessions must occur in person. The claim that day treatment (H2020) direct ABA must occur in person in a clinic setting was not independently verified.

Supervision of CBTs may occur in person or via audio-visual telemedicine. In day treatment, the LBAT must remain on site for all hours the program is in session. Under DOH rule WAC 246-805-330, two face-to-face contacts per month may be in person, on site or by videoconferencing. Direct observation of at least 5 percent of CBT hours per month is required, observing each client at least quarterly. WAC 246-805-330(5) also requires meeting the CBT in person for guidance with new clients and observing the CBT delivering services at least monthly. The DOH monthly 5 percent observation requirement is separate from the Medicaid weekly 5 percent obligation.