Model Coverage Policy for ABA Services: Guidelines for Working with CPT® Codes and Developing Payer Policies

This document has been developed to assist providers, billers, and payers in implementing comprehensive payer policies for the Category I and modified Category III CPT® codes for adaptive behavior (applied behavior analysis; ABA) services. The model policy is also designed to familiarize payers with ABA services and guide them in implementing coverage policies and monitoring utilization of those services.