Blue Cross, BCN accepting claims for applied behavior analysis services with 2019 procedure codes

For dates of service on or after June 1, 2019, Blue Cross Blue Shield of Michigan and Blue Care Network are accepting claims for applied 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 Blue Cross’ PPO and BCN HMO^SM 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 on the Autism pages within Provider Secured Services, which you can access by visiting bcbsm.com/providers and logging in to Provider Secured Services.

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