Aetna Aba Billing Codes. com, on the Provider Education & Manuals page. Utilize th

com, on the Provider Education & Manuals page. Utilize the notes section on last page if needed to complete documentation. Category III Codes 0362T. This Behavioral Health Provider Manual, the EAP Manual and other related communications are posted on Aetna. This guide In this guide, we’ll walk you through the ABA therapy CPT code changes for 2025, their impact on your workflow, and practical steps for a Welcome to the ABA Coding Coalition website the premiere online resource for information about CPT codes for applied behavior analysis services. Here are the key provisions pertaining to ABA services: Carrier Pricing of ABA CPT Codes CMS extended carrier pricing of the CPT codes for adaptive behavior/ABA services through 2026. Aetna considers Applied Behavior Analysis (ABA) experimental, investigational, or unproven for Down Syndrome in the absence of an autism spectrum disorder (ASD) co-morbidity because of insufficient This guide reviews the key ABA CPT codes, highlights recent updates, and provides practical billing tips to help your practice reduce denials and maximize reimbursement. Below is a list of Aetna® is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Include details of other medical/behavior health concerns. Discover the Aetna In July 2020, we adopted new Current Procedural Terminology (CPT ®) billing codes proposed by the American Medical Association for Applied Behavior Analysis (ABA) treatment. Aetna is the brand name used for After receiving authorizations, to bill for the virtual ABA Supervision of Behavior Technicians and Family Training and Guidance, simply include the same procedure code you use for an in- person service, Learn about Aetna’s provider cost estimator and physician fee schedule tools to help you estimate patient costs. Frequently asked questions about CPT codes for applied behavior analysis services. Any new codes were implemented based on CPT code definitions. In 2025, several updates and refinements In times like this, a lot of practitioners and ABA therapists who specialize in group-setting therapy plans will turn to an outside Understand how Aetna insurance covers ABA therapy for children with autism spectrum disorder (ASD). Get tools and guidelines from Aetna to help with submitting insurance claims and collecting payments from patients. Learn about the specifics of your Aetna plan, including As part of our effort to support our providers and improve member access to care, Aetna allows supervisory billing for behavioral health care provided by qualified license-eligible behavioral health . The above list of See our precertification lists or utilize our CPT code lookup to see whether a procedure or service requires prior approval. Note Welcome to the ABA Coding Coalition website the premiere online resource for information about CPT codes for applied behavior analysis services. Key steps include confirming eligibility and prior As part of our effort to support our providers and improve member access to care, Aetna allows supervisory billing for behavioral health care provided by qualified license-eligible behavioral health In 2025, several updates and refinements have been made to ABA-related CPT codes, impacting how providers bill for services. Behavior identification supporting assessment, each 15 minutes of technicians’ time face-to-face with a patient, requiring the following List past & present ABA services the member has received. After receiving authorizations, to bill for the virtual ABA Supervision of Behavior Technicians and Family Training and Guidance, simply include the same procedure code you use for an in- person service, Code Conversion Chart Unsure about codes that payers are using for ABA services? This chart outlines the essential elements of ABA assessment and Applied Behavioral Analysis (ABA) Program Rates effective 4/1/2020 Board Certified Behavior Analyst (BCBA-D) required to possess a doctoral degree in psychology or behavior analysis and pass a Aetna 's Behavioral Health fee schedules provides essential insights for behavioral health providers looking to optimize billing, streamline claims, and maximize The guidance or interpretation used in implementing these codes comes from the Louisiana Department of Health (LDH). Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). There are a number of different methodologies and protocols (particularly related to how many hours of treatment are appropriate per week) consistent with ABA, resulting in ambiguity and suspicion about Billing insurance for ABA therapy involves several steps before and after providing the service. LDH wants to These codes help streamline insurance claims and ensure that ABA services are accurately documented.

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