ABA Code Crosswalk - Category III to Category I CPT codes ...

1 ABA Code Crosswalk - Category III to Category I CPT codes : Effective 1/1/2019. Category III Category III Description Time Category I Category I Code Description Time Beacon Who is Code Code Description present 0359T Behavior identification assessment by the 1 hour/ 97151 Behavior identification assessment, 15 min Initial functional Client, QHP. physician or other qualified healthcare 2 hours administered by a physician or other behavior professional, face-to-face with patient and qualified healthcare professional, each assessment caregiver(s).

2 Includes administration of 15 minutes of the physician's or other and standardized and non-standardized tests, QHP's time face-to-face with patient, reassessment detailed behavioral history, patient and/or guardian(s) administering observation and caregiver interview, assessments and discussing findings interpretation of test results, discussion of and recommendations, and non face-to- findings and recommendations with the face analyzing past data, scoring/. primary guardian(s)/caregiver(s), and interpreting the assessment, and preparation of report preparing the report/treatment plan New New New 97152 Behavior identification supporting 15 min Assessment Client, assessment, administered by one technician technician under the direction of a (QHP may physician or other qualified healthcare substitute).

3 Professional, face to face with the patient, each 15 minutes. 0362T Exposure behavioral follow-up assessment, 30 min 0362T Behavior identification supporting 15 min Functional Client and 2 or includes physician or other qualified health assessment, each 15 minutes of assessment- more care professional direction with technician's time face-to-face with a extreme technicians;. interpretation and report, administered by patient requiring the following behavior QHP. physician or other qualified health care components: *administered by the professional with the assistance of one or physician or other qualified healthcare more technicians.

4 First 30 minutes of professional who is on-site, * with the technician(s) time, face-to-face with the assistance of two or more patient technicians,*for a patient who exhibits 0363T Exposure behavioral follow-up assessment, 30 min 0362T destructive behavior, *completed in an includes physician or other qualified health environment that is customized to a care professional direction with patient's behavior interpretation and report, administered by physician or other qualified health care professional with the assistance of one or more technicians; each additional 30.

5 Minutes of technician(s) time, face-to-face with the patient (List separately in addition to code for primary procedure). CPT is a registered trademark of the American Medical Association. 1 | ABA Code Crosswalk - Category III to Category I CPT codes : Effective 1/1/2019. Category III Category III Description Time Category I Category I Code Description Time Beacon Who is Code Code Description present 0364T Adaptive behavior treatment by protocol, 30 min 97153 Adaptive behavior treatment by protocol, 15 min ABA Client, administered by technician, face-to-face administered by technician under the technician with one patient.

6 First 30 minutes of direction of a physician or other QHP, (QHP may technician time face-to-face with one patient, each 15 substitute for 0365T Adaptive behavior treatment by protocol, 30 min 97153 minutes technician). administered by technician, face-to-face with one patient; each additional 30. minutes of technician time (List separately in addition to code for primary procedure). 0366T Group adaptive behavior treatment by 30 min 97154 Group adaptive behavior treatment by 15 min Group ABA 2 or more protocol, administered by technician, face- protocol, administered by technician clients (up to to-face with two or more patients; first 30 under the direction of a physician or 8), Technician minutes of technician time other QHP, face-to-face with 2 or more (QHP may 0367T Group adaptive behavior treatment by 30 min 97154 patients, each 15 minutes substitute).

7 Protocol, administered by technician, face- to-face with two or more patients; each additional 30 minutes of technician time (List separately in addition to code for primary procedure). 0368T Adaptive behavior treatment with protocol 30 min 97155 Adaptive behavior treatment, with 15 min Direction of Client, QHP;. modification administered by physician or protocol modification, administered by technician may include other qualified health care professional with physician or other QHP, which includes technician/.

8 One patient; first 30 minutes of patient face- simultaneous direction of technician, caregiver to-face time face-to-face with one patient, each 15. 0369T Adaptive behavior treatment with protocol 30 min 97155 minutes modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of patient face-to-face time (List separately in addition to code for primary procedure). 0370T Family adaptive behavior treatment 30 min/ 97156 Family adaptive behavior treatment 15 min Parent training Caregiver and guidance, administered by physician or untimed guidance administered by physician or with or without QHP.

9 Other qualified health care professional other QHP (with or without the patient the child (without the patient present) present), face-to-face with present guardians(s)/caregiver(s), each 15. minutes 2 | ABA Code Crosswalk - Category III to Category I CPT codes : Effective 1/1/2019. Category III Category III Description Time Category I Category I Code Description Time Beacon Who is Code Code Description present 0371T Multiple-family group adaptive behavior 30 min/ 97157 Multiple-family group adaptive behavior 15 min Multiple group treatment guidance, administered by untimed treatment guidance administered by parent training physician or other qualified health care physician or other qualified healthcare professional (without the patient present)

10 Professional (without the patient present). face-to-face with multiple sets of guardians(s)/ caregiver(s). 0372T Adaptive behavior treatment social skills 30 min/ 97158 Group adaptive behavior treatment with 15 min Social Skills 2 or more group, administered by physician or other untimed protocol modifications, administered by a Group clients (up to qualified health care professional face-to- physician or other QHP , face to face 8) and QHP. face with multiple patients with multiple patents', each 15 minutes 0373T Exposure adaptive behavior treatment with 60 min 0373T Adaptive behavior treatment with 15 min Extreme Client and 2 or protocol modification requiring two or more protocol modification, each 15 minutes of behavior more technicians for severe maladaptive technician's time face-to-face with a treatment technicians.