CMS Releases 2020 Medicare Physician Fee Schedule; ABA Codes Remain Carrier-Priced

December 17, 2019

The Centers for Medicare & Medicaid Services (CMS) released the final 2020 Medicare Physician Fee Schedule (MPFS) rule on November 1. It can be found here. Addendum B, which contains all assigned relative value units (RVUs) for services within the MPFS, clearly indicates that the CPT codes for adaptive behavior (ABA) services (97151-97158, 0362T, 0373T) will remain carrier-priced (denoted by “C” in the status column in Addendum B). That means those codes have not been assigned RVUs and will continue to be priced by payers in 2020.