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Applied Behavior Analysis Allowable Services and Coding Guide

Attachment 1 ABA Billing Guidelines Effective January 1, 2019 WVCHIP Document January 1, 2019 Applied Behavior Analysis Allowable Services and Coding Guide : CODE and Rendering Staff Credential Service Description All Services are face-to-face and 1:1 unless otherwise noted. Unit of Service Maximum Units Fee THE FOLLOWING CODES MAY BE USED IN COMBINATION OF UP TO A MAXIMUM OF 40 HOURS PER WEEK AND/OR 8 HOURS WITHIN A 24 HOUR PERIOD OF TIME. THE SERVICE WEEK IS DEFINED AS SUNDAY 12:00AM THRU SATURDAY 11:59PM. H0031 (no change) BCBA/BCaBA level assessment. Completed in order to submit the initial ABA treatment plan for Prior Authorization submission Initial Functional and Behavior Identification assessments: ABAS-II or III - Functional Assessment (Required); ASD Behavior Identification assessments (formal scored assessments); Face-to-face review with patient, parent, guardian(s), caregiver(s) to discuss findings and recommendations for Applied Behavior Analysis Plan; Preparation of ABA Behavior plan inclusive of reinforcements; schedule of such, identification of plan goals, objectives, strategies activities, and reinforcement schedule; Event 1 Annually without a PA; Additional event will require Prior Authorization Maximum of 2 events annually

Applied Behavior Analysis Allowable Services and Coding Guide: CODE and Rendering Staff Credential Service Description – All servi ces ar f-to nd 1:1 unless otherwise noted. Unit of Service Maximum Units Fee THE FOLLOWING CODES MAY BE USED IN COMBINATION OF UP TO A MAXIMUM OF 40 HOURS PER WEEK AND/OR 8 HOURS WITHIN A 24 HOUR PERIOD OF …

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