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November 18, 2021 In March the Defense Health Agency (DHA), which manages the TRICARE Autism Care Demonstration (ACD) program, issued revised policies for that program. They included policies on billing with the CPT codes for adaptive behavior/ABA services that are inconsistent with the code descriptors and related documents published by the American Medical Association as […]

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July 29, 2021 The Centers for Medicare & Medicaid Services (CMS) released the proposed 2022 Medicare Physician Fee Schedule (MPFS) and other proposed rule changes on July 13. The document can be found here. Addendum B, which contains all assigned relative value units (RVUs) for services within the MPFS, clearly indicates that the CPT codes for adaptive […]

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June 3, 2021 The Centers for Medicare and Medicaid Services (CMS) publishes a list of services and the corresponding billing codes that are payable under the Medicare Physician Fee Schedule when furnished via telehealth. Many payers use that list to determine whether to authorize telehealth delivery of services. Although CMS approved the 8 Category I CPT codes […]

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