Autism spectrum disorders (ASD) can be challenging to manage, but Applied Behavior Analysis (ABA) therapy has been demonstrated to be quite successful in treating people with this condition. ABA therapy is a specialized treatment that focuses on improving social, communication, and behavioral skills. This therapy is often recommended for children with ASD, but adults can also benefit.
It’s essential for healthcare providers and insurance companies to understand the correct Current Procedural Terminology (CPT) codes for billing and reimbursing healthcare organizations that provide ABA therapy. CPT codes are widely used in the healthcare industry to describe medical, surgical, and diagnostic services. These codes make it simpler for medical personnel to record patient treatments and services. Accurate CPT codes also help reduce billing errors and ensure that healthcare organizations are reimbursed correctly.
Updated CPT Codes for ABA Therapy (2024 Edition):
In 2024, new updates to the ABA therapy CPT codes have been released. These updates provide more accurate descriptions of the services rendered during ABA therapy sessions. Some of the key ABA codes for 2024 include:
97151: This code represents the assessment of adaptive behavior, which is essential in designing an individualized treatment plan for patients with ASD.
97152: This code is used for the treatment of adaptive behavior, which includes the implementation of behavior intervention strategies.
97153: Under this code, behavior identification and assessment procedures are covered. It helps in diagnosing and understanding the patient’s behavioral challenges.
97154: This bill addresses behavior recognition assessments, particularly for patients who exhibit disruptive behavior. Supervised on site by a qualified health professional, assisted by two or more technicians, these tests are performed in a controlled environment. The payment schedule follows 15-minute increments, highlighting the thorough and meticulous nature of these evaluations.
97155: This code is for group adaptive behavior treatment sessions involving multiple individuals and aims to improve social skills and interactions.
97156: Individual adaptive behavior treatment sessions are covered under this code. It involves one-on-one therapy tailored to the specific needs of the said patient.
97157: This code represents the family adaptive behavior treatment guidance. It involves counseling and guidance for family members to support the patient’s progress outside of therapy sessions.
97158: Under this code, caregiver training is provided. It equips caregivers with the skills and knowledge to implement ABA strategies effectively.
0362T: This code includes group adaptive behavior therapy sessions supervised by a technician under the guidance of a health care professional. Designed to be face-to-face with two or more patients, these sessions promote a therapeutic environment by encouraging social interaction and mutual learning. Billing for this service is based on 15-minute increments, reflecting the structured and intensive nature of group therapy sessions.
0364T: This temporary category III code is used to report adaptive behavior assessments for individuals with ASD.
0373T: This particular code handles adaptive behavioral treatment of protocol changes made by a technician. It involves one-on-one, face-to-face sessions tailored to a patient’s individual treatment needs. Treatment regimens are modified as necessary to accommodate evolving goals and disease progression.
With these new ABA therapy CPT codes, healthcare providers and insurance companies can bill more accurately for ABA therapy services. This ensures that individuals with ASD can continue to receive the specialized care they need to thrive.
If you are thinking about reaching out to an effective medical billing company to ease your burdens and enhance your experience of ABA therapy practice. In that case, we recommend CareCloud for its flexibility and priority of customer care.
Let’s take a closer look at how CareCloud can simplify your life with its comprehensive ABA billing and practice management services.
Efficient Billing:
By automating claim submissions, CareCloud’s billing software reduces errors and ensures correct ABA billing codes are used for prompt reimbursements for your ABA therapy services. This streamlines the billing process, making it more efficient and accurate.
Comprehensive Reporting:
Gain a deep understanding of your practice’s financial health with CareCloud’s detailed reporting and analytics tools. These resources offer insightful information that aids in the decision-making process for your practise.
Scheduling and Appointment Management:
CareCloud’s software helps you manage appointments and schedules more efficiently, reducing no-shows with its scheduling features. This ensures your practice operates smoothly and efficiently.
HIPAA-Compliant:
CareCloud guarantees the security of sensitive patient data with its HIPAA-compliant solutions. This ensures that your patient’s information is kept private and protected.
EHR Integration:
CareCloud’s software seamlessly integrates electronic health records for a unified patient management experience. This integration ensures that you have access to all the patient data you need in one place, making it easier to manage your patients.
Patient Management:
Enhance patient engagement with CareCloud’s online portals, appointment reminders, and communication tools. These tools allow you to connect with your patients more easily and provide them with the best possible care.
Revenue Cycle Management:
CareCloud’s revenue cycle management services optimize your revenue cycle, improving cash flow. This helps you maintain a healthy financial standing and focus on providing exceptional patient care.
Conclusion
The CPT codes for ABA therapy have been modified for 2024 to more accurately reflect the services offered for the treatment of people with autism spectrum disorders (ASD). For healthcare professionals and insurance companies to ensure accurate billing and reimbursement for ABA therapy services, these codes are essential. With the comprehensive healthcare technology solutions of CareCloud, you can streamline your ABA therapy practice, from accurate billing to efficient practice management.
Understanding these codes is essential for everyone responsible for caring for individuals with autism spectrum disorders (ASD), as they play a pivotal role in accessing and delivering quality treatment. Embrace the future of healthcare with CareCloud and Make sure your patients get the finest treatment possible.
