Recent News
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 […]
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 […]
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 […]
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 […]
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 […]