Recent News

The ABA Coding Coalition has learned recently that a number of CPT codes for health behavior assessment and intervention services (96158 – 96171) have been modified for 2020. Those codes are for services to identify and address psychological, behavioral, emotional, cognitive, and interpersonal factors important to the assessment, treatment, or management of physical health problems. The […]

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On July 29, 2019 the Centers for Medicare & Medicaid Services (CMS) released their annual notice of proposed rulemaking (NPRM) for the Medicare Physician Fee Schedule (MPFS). As providers may know, these annual proposed and final rule notices are where CMS publishes modified policies and reimbursement rates for all medical services within the MPFS. In […]

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July 19, 2019 The ABA Coding Coalition comprises representatives of APBA, CASP, Autism Speaks, the BACB, and its healthcare and billing consultant. We will be developing and sharing resources to support the implementation of CPT codes for ABA services and advocating for their proper usage. All of our resources and important updates will be published […]

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January 14, 2019 The Steering Committee for the ABA Services Workgroup has prepared the article, Supplemental Guidance on Interpreting and Applying the 2019 CPT Codes for Adaptive Behavior Services, to assist providers, billers, and payers in using the Category I and modified Category III CPT® codes for adaptive behavior services that went into effect January […]

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November 30, 2018 An important article about the 2019 CPT codes for adaptive behavior services was published in the November issue of the CPT Assistant, a monthly newsletter of the American Medical Association (AMA). It is imperative for providers, billers, and payers to obtain and use that article in implementing the 2019 codes. Through an agreement with the AMA, […]

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December 19, 2018 If you bill health insurance, please read this message carefully. It contains very important information about implementation of the 2019 CPT® codes for adaptive behavior services. Medically Unlikely Edits. As we have noted in several webinars, presentations, and Q&A sessions, the Medically Unlikely Edits (MUEs) for adaptive behavior services will change January […]

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November 6, 2018 On November 1, 2018 the Centers for Medicare & Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule (MPFS) final rule. It includes the following statement regarding the new Category I and revised Category III CPT codes for adaptive behavior services: We note that we intended to assign a contractor price […]

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October 19, 2018 In September, we distributed a code conversion table showing the most common HCPCS and 2014 Category III CPT codes that have been used to report applied behavior analysis (ABA) services to health plans, cross-referenced to the 8 new Category I and 2 modified Category III CPT codes that will go into effect […]

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