New in 2019!
In September, the American Medical Association (AMA) announced the release of the 2019 Current Procedural Terminology (CPT®) code set, including codes for Applied Behavior Analysis (ABA). These new AMA Category I codes will become effective Jan. 1, 2019. In previous use were the temporary Category III codes, instituted to establish unique codes for ABA. Payers will no longer be able to use the Category III codes beginning Jan. 1. As of 2019, most T-codes will no longer exist, replaced by a new set of permanent codes with the following characteristics:
- Eight Category I codes (97151–97158) will replace the Category III codes.
- Two modified codes remain in Category III (0362T and 0373T, for extreme behavior), but are rarely used.
- All codes are now in 15-minute increments, where the old codes ranged from untimed to 60 minutes each.
- The add-on code structure was removed.
For those affected networks, Beacon is providing updated guidance to reflect the new coding structure. Note, some health plans or states may follow a different adoption timeline for the Category I codes. Organizations including the Association of Professional Behavior Analysts (ABPA), Association for Behavior Analysis International (ABAI), Behavior Analyst Certification Board (BACB), and Autism Speaks consulted with the AMA to develop the new codes.
ABA CPT Code Change Webinars
Beacon Health Options accepts ABA providers in all states with the following certifications provided by to provide coverage for autism spectrum disorder:
- Licensed Behavior Analyst
- ABA Credentialing Criteria
- Applied Behavioral Analysis (ABA) Treatment Forms
- ABA Paraprofessional Provider Roster Form
- ABA CPT Temporary Code Crosswalk – through 12/31/2018
- An Overview of ProviderConnect for ABA Providers: Presentation Slides
- ProviderConnect: Behavior Documentation Process: Presentation Slides
- Tips for Writing a Behavior Assessment for ABA Services: Presentation Slides