April 2014

Changes to autism procedure codes coming in April, a reminder about billing guidelines

Blue Cross Blue Shield of Michigan has approved three new procedure codes for billing applied behavior analysis services. These new codes can be used when you bill for dates of service on or after April 1, 2014.

New code	Activity
H2014	Skills training
S5108	Supervision
S5111	Caregiver training

Procedure code G9012 (supervision) that’s currently used when billing for ABA services can’t be used for dates of service after March 31, 2014.

The activity details for procedure codes H0031 and H0032 have changed to align with the state of Michigan guidelines for reimbursable autism codes. This change is effective when you submit claims for dates of service on or after April 1, 2014. See the table below for details.

Code	On or after April 1, 2014	Before April 1, 2014
H0031	Initial assessment	Reassessment
H0032	Reassessment	Initial assessment

Providers should remember that services for ABA should be billed in whole units only when you submit claims.

More information about billing for ABA services
For more details, refer to the Applied Behavior Analysis Billing Guidelines and Procedure Codes document on web-DENIS.

Click on BCBSM Provider Publications and Resources.
Click on Newsletters & Resources.
In the left-hand navigation under “Other Resources,” click on Clinical Criteria & Resources.
Under “Resources,” click on Autism.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2013 American Medical Association. All rights reserved.