Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

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  • AAB: Applied Animal Behavior

    AUT: Autism

    CBM: Clinical/Family/Behavioral Medicine

    CSS: Community, Social, and Sustainability Issues

    DDA: Developmental Disabilities

    EAB: Experimental Analysis of Behavior

    EDC: Education

    OBM: Organizational Behavior Management

    PCH: Philosophical, Conceptual, and Historical Issues

    TBA: Teaching Behavior Analysis

    VRB: Verbal Behavior

14th Annual Autism Conference; Miami, FL; 2020

Event Details


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Invited Paper Session #19
CE Offered: PSY/BACB

ABA Billing Codes Commission: Preserving Best Practices Through Collaboration, Education, Dissemination, and Advocacy

Tuesday, February 25, 2020
12:30 PM–1:20 PM
Regency Ballroom
Area: AUT; Domain: Service Delivery
Instruction Level: Basic
CE Instructor: Julie Kornack, Other
Chair: Ruth Anne Rehfeldt (The Chicago School of Professional Psychology)
JULIE KORNACK (Center for Autism and Related Disorders)
Julie Kornack is the vice president of Government Relations for the Center for Autism and Related Disorders, the world’s largest provider of evidence-based autism treatment. Her work includes identifying, developing, and supporting federal and state initiatives that preserve or increase access to autism services and supports, as well as analyzing the impact of federal and state legislative and regulatory developments on access to mental health services. She is the ABAI representative on the ABA Billing Codes Commission. She is co-author of The Diversity Is in the Details: Unintentional Language Discrimination in the Practice of Applied Behavior Analysis and A Response to Papatola and Lustig’s Paper on Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis in the Treatment of Individuals on the Autism Spectrum, published in Behavior Analysis in Practice, and is the author of The History, Pitfalls, and Promise of Licensure in the Field of Behavior Analysis, published in Handbook of Treatments for Autism Spectrum Disorder. Her analysis of the economics of autism treatment was published in the Handbook of Early Intervention for Autism Spectrum Disorders: Research, Policy, and Practice, and she was an editor of Evidence-Based Treatment for Children with Autism: The CARD Model. She co-founded and serves on the board of directors of the National Coalition for Access to Autism Services and participates in multiple state and national advisory committees and task forces. She was co-chair of Hillary for America’s Disability Policy Health Care Task Force and a co-author of the Democratic National Committee’s Disability Primer for Democratic Candidates.
Abstract:

In the year since the 2019 CPT® I billing codes for ABA took effect, behavior analysts have encountered a wide array of issues, including contradictory interpretations of the codes, arbitrary hour limits, claims denials, and even accusations of fraud. The ABA Billing Codes Commission was established to work collaboratively and transparently to preserve and expand access to ABA that reflects best practices by identifying and resolving issues arising from the adoption of the CPT I codes. In this presentation, we will review the most common concerns, including concurrent billing, hour limits associated with Medically Unlikely Edits (MUEs), direction of the behavior technician, clinical documentation, and valuation, and provide guidance and resources to support the effort of behavior analysts to implement evidence-based ABA. Finally, we will discuss what comes next and how we can work together to promote positive changes in the interpretation and valuation of the billing codes.

Target Audience:

Board certified behavior analysts; licensed psychologists; graduate students.

Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe the purpose of billing code descriptors; (2) discuss the appropriate use of Medically Unlikely Edits (MUEs); (3) the difference between concurrent and duplicate billing; (4) state the difference between supervision and clinical direction; (5) state the elements to consider in valuation of billing codes.
 

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