Maine – Anthem BCBS Adaptive Behavioral Assessment & Tx Code Changes

January 2019 ~

Anthem BCBS Maine instructs the use of new Adaptive Behavior Assessment and Treatment (ABA) CPT® procedure codes, effective January 1.

The new ABA codes should be used with dates of service on or after January 1, 2019, as the old procedure codes will no longer be accepted. It is important to note that the descriptor for all of the new codes represent 15 minute increments of time.

Current ABA treatment authorizations that have already been approved through 2019 will be updated to reflect the new codes for the portion of the service that falls in 2019.  Updated authorization letters reflecting the changes to the authorization will be sent to members and providers.  You do not need to call and request that this update to current authorization take place.  Claims submitted for 2019 dates of service should reflect the new codes.

Source(s): Anthem BCBS Maine Provider Communications; January 2019 Anthem Maine Provider Newsletter;