The ABA Coding Coalition comprises representatives of three of the organizations (Association of Professional Behavior Analysts, Autism Speaks, Behavior Analyst Certification Board) and a consultant who participated on the work group that developed the application to the American Medical Association CPT® Editorial Panel that resulted in the code set for adaptive behavior (applied behavior analysis) services that went into effect January 1, 2019. That code set includes eight Category I and two Category III CPT® codes modified from the Category III (temporary) codes for adaptive behavior services that were issued in 2014 pursuant to a process initiated by the Association for Behavior Analysis International (ABAI). The work group, which included representatives of ABAI and operated from 2015 through the end of March 2019, also developed resources to assist providers and payers with implementing the 2019 code set. The principal representative (Lorri Unumb) for the fourth organization in this Coalition (Council of Autism Service Providers) represented Autism Speaks on the previous work group.
The principal aims of the ABA Coding Coalition are to
- support implementation of the 2019 CPT® code set by ABA service providers and payers by responding to inquiries, developing and disseminating information and resources, and communicating with our constituents and other interested parties
- monitor Medically Unlikely Edits (MUEs) for the code set and submit requests for revisions based on provider feedback and payer implementation
- educate ABA service providers and payers about CPT®, MUE, and related processes
- develop and maintain this website as a repository for coding and reimbursement resources and a portal for inquiries
The ABA Coding Coalition’s operating policies and procedures are described here.
The organizations, their principal and alternate representatives, and their consultant are described below.
APBA is a nonprofit professional organization whose mission is to promote and advance the science-based practice of ABA by advocating for public policies and informing, supporting, and protecting practitioners and consumers. Memberships are available for professionals in behavior analysis and other fields, Registered Behavior Technicians, students, and consumers of ABA services.
Gina Green, PhD, BCBA-D is the Chief Executive Officer of APBA. She has developed and evaluated ABA interventions for people with autism and other developmental disorders, trained and supervised ABA practitioners and students, consulted to several ABA service programs, worked on many licensure and funding laws, and held leadership positions in several professional and parent-professional organizations. Dr. Green served as APBA’s principal representative on the work group described above.
Rebecca Womack, MS, BCBA, LBA is the Associate Vice President of Clinical Standards for Blue Sprig Pediatrics, Inc. She works collaboratively with the Clinical Team by ensuring all clinicians engage in clinical activities that align with industry standards, research, payor policy requirements, and best practice guidelines. She also serves as the President Elect for the Association of Professional Behavior Analysts (APBA), and a member of the Council of Autism Service Providers (CASP) Public Policy Committee. Her experience includes working in group homes, facilities, daycare centers, schools, and family homes. She’s implemented and provided consultation regarding evidence-based therapy across the United States as well as overseas. Whatever the role, her ultimate goal is to make a significant impact through effective and efficient services utilizing the science of behavior analysis.
CASP is a nonprofit association of for-profit and not-for-profit organizations that collectively deliver more than $1 billion in services to 50,000+ children and adults with autism each year. CASP exists to promote high-quality and cost-effective care, and achieves its mission by training organizational leaders, developing standards, advocating for evidence-based practice, and fostering collaboration among stakeholders.
Lorri Shealy Unumb, JD became the Chief Executive Officer of CASP in June 2019 after having served for more than a decade as the Autism Speaks Vice President for State Government Affairs. In her role with Autism Speaks, she spearheaded the autism insurance reform movement that has resulted in 50 states adopting laws that require certain health plans to cover ABA and other services for people with autism. Prior to that she was an appellate litigator with the U.S. Department of Justice and a professor at the George Washington University Law School and the Charleston School of Law. She and her husband Dan founded the nonprofit Autism Academy of South Carolina and wrote the academic textbook Autism and the Law. Ms. Unumb was the principal representative for Autism Speaks on the work group described previously.
Kristen Koba-Burdt, BCBA, LBA is the Director of Clinical Operations for BAYADA Behavioral Health, a not-for-profit organization. She has worked in home, center, community, public school, private school, and residential settings providing services for individuals across the lifespan. She has provided multiple presentations on structuring systems within an ABA organization, clinical judgment and medical necessity, addressing adverse determinations by health plans, and advocacy for expanded access to services for underserved populations. Additionally, Kristen is dedicated to advancing issues related to diversity, equity, and inclusion (DEI) in ABA.
Autism Speaks is a non-profit organization dedicated to promoting solutions, across the spectrum and throughout the life span, for the needs of individuals with autism and their families through advocacy and support; increasing understanding and acceptance of people with autism spectrum disorder; and advancing research into causes and better interventions for autism spectrum disorder and related conditions.
Kelly Headrick serves as the senior director of state government affairs and grassroots advocacy for Autism Speaks, a nonprofit organization dedicated to promoting solutions, across the spectrum and throughout the life span, for the needs of individuals with autism and their families. In this role, she and her colleagues work – together with volunteer advocates and ambassadors – to promote autism research funding, access to critical autism-related supports and services, access to high-quality special education, and to support other issues of concern to the autism community. Prior to joining the staff of Autism Speaks in early 2020, Kelly worked in a variety of state, regional and national roles with organizations including the American Heart Association, Campaign for Tobacco-Free Kids, American Cancer Society and Nurse-Family Partnership. Kelly is based in the Denver, Colorado area where she lives with her husband and teenage children.
The BACB is a nonprofit corporation established in 1998 to meet professional credentialing needs identified by behavior analysts, governments, and consumers of behavior analysis services. Its mission is to protect consumers of behavior analysis services by systematically establishing, promoting, and disseminating professional standards.
Wayne W. Fisher, PhD, BCBA-D, LP is the Henry Rutgers Endowed Professor of Pediatrics in the Robert Wood Johnson Medical School, a core faculty member of the Brain Health Institute, and the inaugural director of the Rutgers University Center for Autism Research, Education, and Service (RU-CARES). Previously he served as executive director of Neurobehavioral Programs at the Kennedy Krieger Institute and the Marcus Behavior Center at the Marcus Institute, where he built highly regarded clinical-research programs in autism and developmental disabilities. Dr. Fisher has published extensively on ABA interventions for people with autism and severe behavior disorders and maintained federal grant support for his research for over 20 years. He has been involved in efforts to obtain CPT® codes for ABA services from the outset, first as a co-author of the ABAI application to the AMA CPT® Editorial Panel that ultimately resulted in the 2014 Category III codes for adaptive behavior services, then as an ABAI representative on the work group described above, and now as a BACB representative on the ABA Coding Coalition.
James E. Carr, PhD, BCBA-D is the Chief Executive Officer of the BACB. In addition to his work on credentialing ABA practitioners, Dr. Carr has developed and evaluated ABA interventions for people with developmental disorders and for training practitioners, led state and regional behavior analysis associations, and trained ABA practitioners-to-be at the University of Nevada-Reno, Western Michigan University, and Auburn University. He served as the BACB’s principal representative on the aforementioned work group.
Jenna Minton, JD is the President of Proactive Strategies LLC, which specializes in guiding client organizations in the development and subsequent valuation of CPT® codes and related American Medical Association and Centers for Medicare & Medicaid Services regulatory processes. She also serves as the Director of Operations for Residential Options, Inc., which serves about 300 clients with autism and other developmental disabilities at three learning centers in Michigan. From 2016 through present, Ms. Minton has guided and contributed substantially to the efforts of the work group described above.