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July 19, 2023 On July 13, 2023 the Centers for Medicare & Medicaid Services (CMS) issued the Notice of Proposed Rulemaking (NPRM) for the 2024 Medicare Physician Fee Schedule (MPFS). Here are the key provisions affecting ABA services: Proposed Carrier Pricing of ABA CPT Codes CMS proposes to extend carrier pricing of the CPT codes […]

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August 16, 2022 Recently the Centers for Medicare & Medicaid Services (CMS) published the proposed Medicare Physician Fee Schedule (MPFS) and proposed rule changes for 2023. The agency is proposing that the CPT codes for adaptive behavior/ABA services (97151 – 97158, 0362T, 0373T) remain carrier-priced throughout 2023, as they have been since they went into effect […]

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January 19, 2022 The ABA Coding Coalition has updated the Model Coverage Policy for Adaptive Behavior Services, which was initially released in September 2020. The updated version includes two additional modifier codes that some payers want providers to use to indicate services that are being provided via telehealth, and some additional ICD-10 and corresponding DSM-V […]

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