CMS Proposes Rules for Calendar Year 2023 Pricing and Telehealth Approval Status of CPT Codes for ABA Services
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 […]
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 […]
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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