Access to ABA Therapy for Autism Set to Expand in 2019

Recent changes to codes used by medical providers to bill insurance companies have paved the way for better coverage for individuals utilizing applied behavior analysis (ABA) for autism and other related disorders.

Beginning January 1, 2019, Current Procedural Terminology (CPT) codes for the popular autism service will switch from “temporary” to “permanent,” meaning the legitimacy of ABA treatment has been proven effective under rigorous testing standards. As a result, the code revisions will further expand reimbursement requirements and recognize ABA as medically necessary under certain circumstances.

The CPT changes are welcome news for autism advocates, who have long been pushing for greater access to ABA therapy, which uses behavioral learning through goal setting and positive reinforcement, improving language, social and communication skills in the process.

The upcoming changes related to ABA billing include the following:

• Eight new Category I (permanent) codes for services
• A revision of two Category III (temporary) codes
• No more add-on codes, which previously complicated the billing process
• ABA will be billed in uniform time increments of 15 minutes

The 2019 CPT codes should lead to a reduction in insurance claim denials related to ABA treatment, which is a big win for families seeking treatment for loved ones that have previously been unable to pay for care.

For more information, visit https://www.autismspeaks.org/advocacy-news/new-cpt-codes-aba-billing

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H/T: [Disability Scoop]