Private Insurance

Credentialing with Insurance Companies

If you are going to accept insurance (including private/employer, Medicaid through the MCOs, TRICARE, etc.), you ...

Telehealth Ongoing

While COVID-19 was difficult for our providers, clients, families, schools, and pretty much everyone in the world, ...

TRICARE Manual Changes 2021

If you are a provider who takes TRICARE, you probably already know about the manual changes. Click here for the ...

BCBAs and Credentialing

Here is a link to the original bill and the final law. Also see this memo from DMAS for more information with ...

More CPT Code Resources

Have you seen this Web site?  It has up-to-date info on CPT codes and is a great resource.  Plus there is an FAQ ...

More CPT Code Information

  Please see this message from APBA, the BACB, Autism Speaks, and ABAI: The Steering Committee for the ABA Services Workgroup (representatives of the organizations shown above and their CPT® consultant) has prepared the article Supplemental Guidance on Interpreting and Applying the 2019 CPT® Codes for Adaptive Behavior Services  (available here and in the Members Only/Health Insurance Coverage section at […]

More CPT Code Information – MUE

Please see this important message from APBA: December 19, 2018 Dear colleague: If you bill health insurance, please read this message carefully. It contains very important information about implementation of the 2019 CPT® codes for adaptive behavior services. Medically Unlikely Edits. As we have noted in several webinars, presentations, and Q&A sessions, the Medically Unlikely Edits […]

More CPT Code Information – Provider Rates

APBA sent more information about provider rates.  The AMA has determined that they will be set by the insurance companies.  Now is a good time to negotiate!  APBA has information on their site about negotiation tactics for their members –  Here is the email sent on 11/4/18: On November 1, 2018 the Centers for […]

More CPT Code Information – New Codes Active Jan 2019

Note, a revision was sent out in mid October: In September the Steering Committee for the national workgroup comprising representatives of the organizations shown above distributed a code conversion table showing the most common HCPCS and 2014 Category III CPT codes that have been used to report applied behavior analysis (ABA) services to health plans, […]

CPT Code Changes Coming Soon (Jan 2019)

Thank you to APBA and the Steering Committee for helping behavior analysts get new billing codes for ABA!  Here is some information they recently sent to members. VABA is an affiliate of APBA.  For more information about APBA or to join, see   “On behalf of the Steering Committee for the project that developed […]

CPT Codes Update 2017

There have been many questions about upcoming changes to the CPT codes for ABA services.   CPT stands for Current Procedural Terminology and CPT codes are what practitioners use to bill insurance companies.  More information can be found on ABAI’s Practice Resources Web page. At one point it was thought that some of the new […]

Law affecting coverage of ABA

Click here to see a new law with an emergency clause that dials back the stated size of a small company from 100 to 50 as it was until January of this year.  Therefore, companies with 51 to 100 employees are still required to cover ABA for those diagnosed with autism spectrum disorder.