Recent News

Supplemental Guidance Resource

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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CPT Assistant article

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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MUEs & Payer Implementation

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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CMS Medicare Physician Fee Schedule final rule published

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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Revised Code Conversion Table

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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Code Conversion Table

September 4, 2018 To help payers and providers achieve consistency in utilization and implementation of the new codes, we have prepared this coding conversion crosswalk. It indicates the most common HCPCS and 2014 Category III CPT codes that have been or are being used by payers to report ABA services, and cross references those older […]

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CMS Notice of Proposed Rule Making

August 16, 2018 The Centers for Medicare & Medicaid Services (CMS) has released its annual Notice of Proposed Rule Making (NPRM) for the 2019 Medicare Physician Fee Schedule (MPFS). In the NPRM, CMS did not discuss valuation for the eight new Category I codes and two modified Category III codes that will be used to […]

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