Current Procedural Terminology (CPT) Category III codes provide recognition from the American Medical Association (AMA) that applied behavior analysis (ABA) is an empirically supported and medically necessary intervention.
For the past several years ABAI has been working with the AMA, with the help and support of Drs. Travis Thompson and Wayne Fisher, to establish new billing procedures for ABA and related services for people with autism and other behavior-related conditions. As a result there are newly approved AMA CPT codes intended for billing ABA services. These new codes define procedures and services performed by behavior analysts.
Codes were implemented July 1, 2014. ABAI is in the process of drafting a letter about these new codes (CPT III tracking codes 0359T-0374T) that you can send to your clients’ or patients’ insurers requesting coverage. These codes may or may not be covered by insurers at this point. Over time, these codes will result in systematic and standardized valuation of ABA services, as well as simplify and streamline the billing and collection processes for ABA services.
CPT Code Resources
Behavior Analysis CPT Code Workshop: Part 1
Behavior Analysis CPT Code Workshop: Part 2
Adaptive Behavior Assessment and Treatment: CPT Coding Summary
Adaptive Behavior Assessment and Treatment Algorithm
Adaptive Behavior Assessments and Treatment Descriptors for July 1, 2014 Reporting—©American Medical Association 2014. Published in CPT Assistant: Official source for CPT coding guidance (June 2014) Volume 24 (6).
Frequently Asked Questions
CPT Code Training Dates