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January 2019

AMA updates applied behavior analysis codes for autism

If you currently use the following codes to bill applied behavior analysis for autism services to Blue Cross Blue Shield of Michigan, you need to change the codes you bill starting Jan. 1, 2019:

  • *0359T-*0361T
  • *0363T-*0372T
  • *0374T

The above-listed T codes are ending Dec. 31, 2018, following the American Medical Association’s procedure code changes. On Jan. 1, 2019, the previous codes will be replaced with the following:

  • *0362T
  • *0373T
  • *97151-*97158

Starting with dates of service in 2019, you should use one of the appropriate procedure codes only if you used the T codes in 2018.

Prior authorizations for applied behavior analysis that were requested and approved under the T codes will remain valid. You don’t need to request a new authorization to accommodate the change in procedure codes.

The code change doesn’t apply to any Blue Cross services that didn’t use these T codes for autism specific benefits in 2018. The change also doesn’t apply to Blue Care Network.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

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