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ABA Billing Guidelines & Tips 

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Someone writing down ABA billing guidelines

Applied Behavioral Analysis (ABA) billing codes play a huge role in your practice’s ability to offer top-tier care to your clients. Without the proper management of your revenue cycle and deep comprehension of CPT ABA billing codes, your practice will sink.  

With each passing year, these details grow in complexity and demand more of your billing team. The good news is that with the right combination of managed billing and ABA billing software, your practice can expand its knowledge and comprehension of ABA billing codes and revenue cycle management (RCM).  

The Role of Revenue Cycle Management   

Revenue Cycle Management is comprised of your organization’s entire billing process. From the point of first contact through the time a bill is paid in full, the revenue cycle is functioning. ABA billing codes are an integral part of your organization’s revenue cycle. Your RCM process is what determines the growth potential and operational efficiency of your practice. 

Understanding ABA Billing 

ABA billing grows more complex with each year as ABA billing codes change and evolve and the specialty becomes more elaborate. The key to understanding and optimizing billing within your specialty is to have a firm grasp of ABA billing codes. Once you can perfect your billing process, you can focus more of your energy on your clients and spend less time worrying about whether or not you are getting paid for the services you offer.  

ABA Billing Codes 

The most used ABA billing codes are:  

 97151 – Behavior Identification Assessment  

0362T – Exposure Behavioral Follow-Up Assessment  

97155 – Adaptive Behavior Treatment w/ Protocol Modification  

97156 – Family Adaptive Behavior Treatment Guidance  

97157 – Multiple Family Group Adaptive Behavior Treatment Guidance  

0373T – Exposure Adaptive Behavior Treatment with Protocol Modification  

97152 – Observational Behavioral Follow-Up Assessment  

97153 – Adaptive Behavior Treatment by Protocol  

97154 – Group Adaptive Behavior by Protocol  

97158 – Adaptive Behavior Treatment Social Skills Group  

The ability to apply these ABA billing codes appropriately and execute a clean claim is essential to receiving a timely payment and avoiding lost revenue.  

The Benefit of Insurance Claim Management for ABA Therapy 

The good news is you do not have to do it alone. ABA practice management software, with billing features AND managed billing services are available to help you optimize your application of ABA billing codes and streamline your therapy billing.  

Connection to Experts  

With Revenue Cycle Management an expert team of billers keeps track of all updates, changes in regulations, and adjustments in ABA billing codes so that you do not have to. Transition your claims management to a high-functioning ABA therapy biller and hand over the burden to a team of experts. They will manage everything from claim generation to submission, following up on every claim to make sure you are getting paid. Rather than juggle the burden of ABA billing codes and claims management, you can trust that a team of qualified experts is perfecting the process.  

Timely Payment  

The truth of the matter is that your practice needs payments in order to keep helping clients. ABA therapy is complex and requires much of your attention, but billing can quickly become a distraction when you are constantly having to chase down payments and understand ABA billing codes.  

Rather than do this, claims management for ABA therapy offers peace of mind that payments are on the way. Your team will no longer be the ones in charge of tracking down claims, dealing with insurance companies, and searching for payments. A team of experts will help you get paid quickly for submitted claims, reducing errors in ABA billing codes and removing inefficiencies found in the billing workflow.  

Focus on Care  

Your time is your own again when you decide to partner with a vendor of claims management services for ABA therapy. They will take over conversations with payers, tracking and managing your claims, and training their own staff so that you do not have to.  

Instead, your team can return its focus to what really matters, client care. Your clients deserve a dedicated provider who is not distracted by the burden of ABA billing codes and claims. Providers are liberated from these responsibilities through a quality partnership where they can then focus solely on their clients.  

The Impact of ABA Billing Software 

Your practice might also benefit from the implementation of a high-functioning ABA billing software.  

Collect Payments  

While coverage for ABA therapy continues to expand each year, many providers still find themselves relying heavily on the collection of client payments. The issue is that many of these providers are not offering the right combination of payment options to encourage their clients to make more payments on their balances. With ABA billing software, your practice can create, print, and email invoices/bills to patients who need them.  

The software also promotes the collection of payments by offering features such as the ability to easily create and distribute invoices, process credit card payments, save cards on file for future payments, and allow individuals to make payments on their client portal.  

By offering a wide variety of options for your clients to make payments, they are more likely to pay their therapy bills.  

Electronic Clearinghouse  

Having access to a quality clearinghouse is essential to making sure your claims are clean and ready for approval. A clearinghouse functions as a middleman between the provider and the insurance payer. It scrubs each claim for errors (like incorrect ABA billing codes) prior to submission to make sure providers have their best chance at approval. This is an incredible tool to help providers minimize the risk of errors and optimize the opportunity for payments/reimbursements.  

With an electronic clearinghouse, providers can worry less and less about whether or not the claims they submit are going to be approved and, instead, focus more on the clients who depend on them.  

Reporting/ Analytics  

Your billing software is useful for more than just submitting claims. Providers can also access incredible tools like daily billing reports that help them understand their practice financials, track growth, and identify gaps. This feature also offers invoice aging for outstanding bills as well as staff billing reports for payroll management.  

Keep Track of Current CPT ABA Billing Codes/Code Modifiers  

Stay up to date with the latest developments in CPT ABA billing codes/code modifiers right inside your therapy billing software. This tool empowers providers to stay on top of changes in ABA billing codes with ease rather than risk falling behind.  



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