Starting June 1, BCN and Blue Cross are accepting applied behavior analysis claims with 2019 procedure codes

For dates of service on or after June 1, 2019, BCN and Blue Cross are accepting claims for behavior analysis services billed with the following codes:

• *97151
• *97152
• *97153
• *97154
• *97155
• *97156
• *97157
• *97158
• *0362T
• *0373T

Claims billed with the following codes will still be honored:

• H0031
• H0032
• H2019
• H2014
• S5108
• S5111

This applies to BCN HMO^SM and Blue Cross’ PPO members. All services continue to require authorization.

Billing guidelines

We're updating the ABA billing guidelines to reflect the 2019 codes. Look for the updated guidelines sometime in June on the Autism pages within Provider

Secured Services, which you can access by visiting bcbsm.com/providers and logging into Provider Secured Services. Then:

• To access the BCN Autism page:
  
  1. Click BCN Provider Publications and Resources (on the right).
  2. Click Autism(in the left navigation).
  3. Click Applied Behavior Analysis Billing Guidelines and Procedure Codes under the "Autism provider resource materials" heading.

• To access the Blue Cross Autism page:
1. Click BCBSM Provider Publications and Resources (on the right).
2. Click Clinical Criteria & Resources(in the left navigation).
3. Scroll down and click Autism (in the Resources section).
4. Click Applied Behavior Analysis Billing Guidelines and Procedure Codes under the "Autism provider resource materials" heading.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association. All rights reserved.