Special Learning · Field guide · Pennsylvania · September 3, 2026

Asked on r/Autism_Parenting, December 15, 2023: “What to do while waiting for IBHS? My son (3.5 years) was recently diagnosed with autism. We're on the waiting list for IBHS. Without knowing how long that wait may be, we wanted to try to get him involved with some other services in the meantime. What can we/should we be looking to do?? I'm very new to the world of autism, and still don't know what I don't know.” source

How to get IBHS for your child in Pennsylvania

IBHS is Pennsylvania's Medicaid program for in-home, in-school and in-community behavioral health services for children and young adults under 21. It replaced the old wraparound program (BHRS) under regulations issued in 2019, with the transition finished in January 2021. If you have a written order and Medical Assistance, the state's rules say what has to happen next and how fast. Almost nobody tells parents those rules. This page does, with the regulation section beside each one so you can check us.

It covers what IBHS is and whether it's the same as ABA, who's eligible, the four steps from written order to services, who'll actually be in your house, what you're entitled to along the way, what to do while you wait, and what to do when something goes wrong.

1. What IBHS is, and whether it's the same as ABA

Asked on r/ABA, June 5, 2024: “Is IBHS the same as ABA therapy?” source

No. ABA is one of the things IBHS can pay for. The regulation defines IBHS as “an array of therapeutic interventions and supports provided to a child, youth or young adult in the home, school or other community setting.” (55 Pa. Code § 5240.2) The state's payment rules split that array into three categories: (§ 1155.36)

• Individual services: behavior consultation, mobile therapy, and behavioral health technician (BHT) services. If your child has “a BC and a BHT,” this is the track you're on.
• ABA services: behavior analytic services, behavior consultation–ABA, assistant behavior consultation–ABA, and BHT–ABA services. This is the track where a behavior analyst designs the plan and technicians deliver it.
• Group services, including evidence-based therapies (EBT) delivered to more than one child. Parent-Child Interaction Therapy (PCIT), for example, can be delivered as an IBHS evidence-based therapy. (DHS IBHS FAQ, Service Description Q13)

So a family with “a behavioral consultant and a 1:1 wraparound” is receiving IBHS individual services, not ABA services. Both are IBHS. The written order says which one your child gets, and how much.

One more thing the FAQ says plainly: IBHS isn't only for autism. “All IBHS are available to children, youth, and young adults if they are medically necessary regardless of the child's, youth's or young adult's behavioral health diagnosis.” (DHS IBHS FAQ, Service Provision Q2)

2. Who can get it

• Age. The regulation defines a child as under 14, a youth as 14 to under 18, and a young adult as 18 to under 21. (§ 5240.2) Put together, IBHS runs from birth until the day before a 21st birthday.
• Diagnosis. Services are for children “with a behavioral health diagnosis” (§ 1155.1(a)) that appears in the current DSM or ICD. (§ 1155.32(a)(1)(iii))
• Payment. The Medical Assistance program pays “when the services are medically necessary and provided to eligible children, youth or young adults with a behavioral health diagnosis by licensed IBHS agencies enrolled in the MA Program.” (§ 1155.1(a)) If your child has Medicaid, this page applies. If you're on private insurance only, IBHS as described here does not; ask your plan what it covers.

3. Step 1: the written order

Nothing starts without it. The order has to come from a face-to-face visit and be “written by a licensed physician, licensed psychologist, certified registered nurse practitioner or other licensed professional whose scope of practice includes the diagnosis and treatment of behavioral health disorders and the prescribing of behavioral health services.” (§ 1155.32(a)(1)(ii); DHS IBHS FAQ, Written Order Q3) Your pediatrician can write it. So can the psychologist who did the evaluation.

A valid order has to contain four things: (§ 1155.32(a)(1)(iv))

1. the clinical information that supports why the service is medically necessary;
2. the maximum number of hours of each service per month;
3. the settings where services may be provided (home, school, community);
4. the measurable improvements that would tell everyone when services can be reduced, changed or ended.

The state is specific about item 2. “It is not sufficient for the order to just state that ABA services are recommended.” An ABA order has to name the maximum hours of each ABA service per month. (DHS IBHS FAQ, Written Order Q9) If the order you're holding just says “ABA recommended,” an agency can't bill against it. Go back and get it completed before you start calling agencies.

The order must be dated within the 12 months before services start (§ 1155.32(a)(1)(i)), and it isn't a one-time document: continued services need a fresh order written within 12 months. (§ 1155.32(a)(6)) Put the renewal date in your calendar now.

You don't need a separate “best practice evaluation” first. The FAQ says one “does not need to be conducted but can be conducted if clinically indicated.” (DHS IBHS FAQ, Written Order Q2) If someone tells you your child can't start until a second evaluation is done, ask them which rule requires it.

4. Step 2: your BH-MCO and finding an agency

Pennsylvania runs Medicaid behavioral health through county-based managed care. “Each HealthChoices consumer is assigned a Behavioral Health Managed Care Organization (BH-MCO) based on his or her county of residence,” and “members, then, have a choice of Behavioral Health Care providers within the BH-MCO's network.” (PA DHS, Behavioral Health MCOs) The BH-MCO is the organization that authorizes and pays for IBHS in your county. Its member services line is the number to call.

Source: PA DHS, Behavioral Health MCOs page and the DHS "BH-MCO Contacts and Counties Served" list, read September 3, 2026. The member services number is in the handbook the MCO mailed you; DHS's list linked below also carries each MCO's contacts.

How to find an agency, in the state's own words: “You can work with your BH-MCO to find a provider available through your provider directory and call and make an appointment to establish care,” and “If you're having trouble finding a provider, contact your BH-MCO.” (PA DHS, Request Behavioral HealthChoices Program Services) DHS also runs a public search at https://www.humanservices.dhs.pa.gov/human_service_provider_directory/ where you can filter for licensed IBHS agencies.

And if an agency takes your order and can't serve your child, the rule is on your side: the agency “must notify the child's BH-MCO so the BH-MCO can work with the child's family to find a provider who is able to provide the services included in the written order.” (DHS IBHS FAQ, Licensing Q15) A waitlist isn't the end of the road. Call the BH-MCO and say the order exists and no one is serving it.

5. Step 3: the assessment

Once an agency starts, the clock runs. For individual services, “within 15 days of the initiation of services and prior to completing an ITP, a face-to-face assessment shall be completed” by someone qualified to provide behavior consultation or mobile therapy. (§ 5240.21(a)) For ABA services the window is 30 days, and the assessor must be qualified to provide behavior analytic or behavior consultation–ABA services. (§ 5240.85(a)) The first day of the assessment counts as the first day of services. (DHS IBHS FAQ, Service Provision Q4)

You're part of it. “The assessment shall be completed in collaboration with the child, youth, young adult or parent, legal guardian or caregiver.” (§ 5240.21(b); § 5240.85(b)) It has to look at your child “across the home, school, and other community settings,” not just in one room. (§ 5240.21(c)(7); § 5240.85(c)(6); DHS IBHS FAQ, Assessment Q11) A functional behavior assessment (FBA) counts as the assessment if it meets those requirements. (DHS IBHS FAQ, Assessment Q5)

The assessment must be reviewed and updated at least every 12 months, or sooner if you ask, if there's a crisis, if the caregiver changes, or if there's been no progress in 90 days. (§ 5240.21(e)(1)–(7)) “If you ask” is in the regulation. Use it.

6. Step 4: the treatment plan (ITP) and your signature

The Individual Treatment Plan is the document that says what will be worked on, by whom, how often, and how you'll know it's working. For individual services it must be written within 30 days after services start; (§ 5240.22(a)) for ABA services, within 45 days. (§ 5240.86(a))

Three rights sit in this step:

• It's written with you. “The ITP shall be developed in collaboration with the child, youth, young adult or parent, legal guardian or caregiver of the child or youth, as appropriate.” (§ 5240.22(e); § 5240.86(e))
• You sign it, and every update. “The ITP and all updates shall be reviewed, signed and dated by the youth, young adult or parent or legal guardian of the child or youth, and the staff person who completed the ITP.” (§ 5240.22(h); § 5240.86(h)) If a plan is running that you never signed, that's a compliance problem for the agency, not for you.
• Nothing starts without your written consent. “Prior to the initiation of individual services, the IBHS agency shall obtain written consent to receive the individual services identified in the written order from the youth, young adult or parent or legal guardian.” (§ 5240.74(b); § 5240.84(b) for ABA)

The ITP is reviewed and updated at least every 6 months, or sooner on named triggers that include your request. (§ 5240.22(f); § 5240.86(f))

7. Who's on the treatment team

The regulation's word for the group that plans your child's care is the treatment team: “Individuals involved in a child's, youth's or young adult's treatment. Members of the treatment team may include the child, youth, young adult, parents, legal guardians, caregivers, teachers, individuals who provide services and any individual chosen by the child, youth, young adult, parents or legal guardians.” (§ 5240.2; DHS IBHS FAQ, Service Provision Q3)

Two things follow. You're a member, not a guest. And “any individual chosen by” you means you can bring a grandparent, an advocate, your child's speech therapist, or a friend who takes good notes. You'll still hear older names for these meetings from the BHRS days; whatever someone calls it, the current rule is the one above.

8. Who'll be in your home, and what each person may do

Asked on r/Autism_Parenting, May 2, 2024: “Located in PA. We currently don't receive ABA. Just the IBHS with a behavioral consultant and a 1:1 wrap around services.” source

On the ABA services track, the regulation draws the lines like this: (§ 5240.87)

• Behavior analytic services and behavior consultation–ABA: “clinical direction of services... development and revision of the ITP; oversight of the implementation of the ITP and consultation with a child's, youth's or young adult's treatment team regarding the ITP.” (§ 5240.87(a)) Only behavior analytic services include functional analysis. (§ 5240.87(b)) This is the person who designs the plan, and it's the credential to check first. Our guide to who certifies behavior analysts shows how to verify a BCBA in five minutes.
• Assistant behavior consultation–ABA: assists the analyst “and providing face-to-face behavioral interventions.” (§ 5240.87(c))
• BHT–ABA: “implementing the ITP.” (§ 5240.87(d)) This is the person who'll be with your child the most hours.

And the sentence every parent should know: an assistant or BHT–ABA “may not provide interventions requiring skills, experience, credentials or licensure that the individual does not possess.” (§ 5240.87(e)) The technician follows the plan; the analyst writes it. If the technician is changing the plan on the fly, ask who approved the change.

On the individual services track, the behavior consultant (BC) or mobile therapist (MT) is the graduate-level clinician who assesses and writes the ITP, and the behavioral health technician (BHT) delivers it. (§ 1155.36(1); § 5240.21(a)) The family in the question above has exactly that: a BC and a BHT.

9. Where services can happen

“IBHS shall be delivered in home or community-based, clinically appropriate settings as identified in the written order and ITP.” (§ 5240.23(c)) School counts: “Individual services, ABA services and group services can be provided in a school.” (DHS IBHS FAQ, Service Provision Q1) Center-based ABA is allowed too, in a “community like setting.” (DHS IBHS FAQ, Service Provision Q5) The settings have to be written into the order and the plan, so if you want school hours, make sure the order names school.

10. While you wait

Back to the question this page opened with. The regulation doesn't set a maximum wait, and we won't pretend it does. What it does give you is leverage and a list.

• Keep the order alive. It expires 12 months from the date it was written. (§ 1155.32(a)(1)(i)) If the wait runs long, get it renewed before it lapses so you don't restart the process.
• Call the BH-MCO, not just the agency. The agency's waitlist is the agency's problem; the BH-MCO's job is to find a provider in its network. (PA DHS; DHS IBHS FAQ, Licensing Q15) Say the words: “I have a written order for IBHS dated [date] and no agency is serving it.”
• Ask about the other IBHS category. If ABA services have a long wait, ask whether individual services or an evidence-based group therapy (PCIT is one) are available sooner. (§ 1155.36; DHS IBHS FAQ, Service Description Q13) Both are IBHS. That means a new order naming the different service, so ask the prescriber at the same time.
• Keep what you already have. Speech, OT and Early Intervention through your Intermediate Unit are separate systems with separate rules, and nothing in the IBHS regulations requires you to stop them when IBHS starts. Bring those providers onto the treatment team when IBHS starts. (§ 5240.2)
• Crisis line. “Call or text 988 to receive free and confidential support from a trained counselor 24 hours a day, 7 days a week.” (PA DHS)

11. If something goes wrong

Three things are written into the IBHS rules themselves:

• Restraint. If a manual restraint is used on your child, the agency's own policies “must include how the treatment team will be notified within 24 hours.” (DHS IBHS FAQ, Restrictive Procedures Q1) You're on the treatment team. If you heard about a restraint days later, or not at all, that's reportable.
• Discharge for missed sessions. An agency can't quietly close your case. Discharge for non-attendance requires that the child “failed to attend scheduled IBHS for 45 consecutive days without any notification” and that the agency made “at least three attempts to contact” the family first. (§ 5240.31(a)(6))
• What you get at discharge. The agency must give you contact information for every service your child was referred to, and for the local crisis intervention service. (§ 5240.31(b)) The discharge summary must be completed within 45 days. (§ 5240.32(b)(1))

Disputes with the BH-MCO run through the HealthChoices complaint, grievance and fair-hearing process, which is spelled out in the member handbook your MCO sent you. The state's model language draws the line this way: a complaint is “when you tell [the MCO] you are unhappy with [the MCO] or your provider or do not agree with a decision”; a grievance is when the MCO “denies, decreases, or approves a service or item different than the service or item you requested because it is not medically necessary” and you disagree. (PA DHS, Complaints, Grievances and Fair Hearings) Your provider can file a complaint for you if you consent in writing. Deadlines are short (the model language uses 60 days for a complaint), so read the notice the day it arrives. For free legal help, the same DHS document points to the Pennsylvania Health Law Project at 1-800-274-3258.

If the problem is the agency's licensing conduct rather than a coverage decision, the licensing body is OMHSAS. Its field-office numbers are on the DHS IBHS page linked in the sources.

12. The clock, on one page

13. Sources

• 55 Pa. Code Chapter 5240, Intensive Behavioral Health Services (§§ 5240.1–5240.111): definitions § 5240.2; assessment §§ 5240.21, 5240.85; ITP §§ 5240.22, 5240.86; settings § 5240.23; discharge §§ 5240.31, 5240.32; consent §§ 5240.74, 5240.84; ABA service roles § 5240.87. https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter5240/chap5240toc.html
• 55 Pa. Code Chapter 1155, Intensive Behavioral Health Services (payment): § 1155.1 scope; § 1155.32 written order and payment conditions; § 1155.36 covered services. https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter1155/chap1155toc.html
• PA Department of Human Services, Office of Mental Health and Substance Abuse Services. Intensive Behavioral Health Services (IBHS) Frequently Asked Questions, February 2022. https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-providers/documents/intensive-behavioral-health-services-(ibhs)/ibhs-faq-updated-02-22-22.pdf
• PA Department of Human Services. Intensive Behavioral Health Services (IBHS) page, including OMHSAS field-office contacts. https://www.pa.gov/agencies/dhs/resources/medicaid/bhc/ibhs
• PA Department of Human Services. Behavioral Health MCOs. https://www.pa.gov/agencies/dhs/resources/medicaid/bhc/bhc-mcos
• PA Department of Human Services. Request Behavioral HealthChoices Program Services. https://www.pa.gov/services/dhs/request-behavioral-healthchoices-program-services
• PA Department of Human Services. Human Services Provider Directory. https://www.humanservices.dhs.pa.gov/human_service_provider_directory/
• PA Department of Human Services, HealthChoices. Complaints, Grievances, and Fair Hearings (model member-handbook language). https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/healthchoices/hc-services/documents/Complaints%20and%20Grievances%20Information.pdf

Written for Special Learning. Clinical review: Camila Sandoval (AI), Chief Clinical Officer. Regulations and DHS pages were read at source on September 2 and 3, 2026; the state's documents are the record and this page is the map. This page explains the rules; it isn't legal advice, and your BH-MCO's member handbook governs your plan's deadlines. Report an error to info@special-learning.com and we will fix it here, with the date.