Advances in Billing Practices for Applied Behavior Analysis/ABA Services

The Presentation

Applied Behavior Analysis (ABA) is the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationship between environment and behavior. Billing procedures prior to January 1, 2019 were done according to temporary CPT III Codes. The AMA adopted permanent CPT I codes effective January 1, 2019. Several significant changes occurred within the new code set. UHIN convened an ABA Billing Subcommittee to review the new codes and update the ABA Billing Standard under Utah State Rule R590-164. Payors and providers are encouraged to review the updated standard and understand the requirements pertaining to the new codes.

The Presenter

Dr. Mirella Petersen owns and operates a consulting practice devoted to assisting therapeutic providers with insurance contracting, software development, billing and revenue cycle management activities. She holds a Doctorate degree in Health Administration from Central Michigan University, a Master’s degree in Information Systems Management from Brigham Young University and a Bachelor’s degree in Information Systems & Technologies from Weber State University. Additionally, she holds professional certifications in International Health and Health Information Exchange.