| Abstract: Since 2009, ABAI has been working with the American Medical Association to establish billing codes for ABA. In 2014, the AMA adopted Current Procedural Terminology (CPT) Category III (or temporary) codes for adaptive behavior services, and the majority of those codes became Category I (permanent) codes, effective January 1, 2019, as a result of joint efforts by ABAI, APBA, Autism Speaks, and the BACB. The AMA codes recognize that ABA services represent empirically supported and medically necessary interventions. As insurers, health plans, and managed care organizations have implemented the CPT I codes, behavior analysts have grappled with a wide array of issues, including contradictory interpretations of the codes, claims denials, and newly imposed hour limits. In this presentation, we will review the activities that the codes are intended to capture, identify the varying interpretations of the codes by funding sources, and discuss what comes next as we work to preserve and expand access to ABA that reflects best practices. |