Fully licensed psychologists can be reimbursed for ABA services

Blue Cross Blue Shield of Michigan and Blue Care Network can reimburse fully licensed psychologists for applied behavior analysis services if the services are within their education, training and experience.

To qualify to be reimbursed for ABA services, the psychologist must:

• Be contracted with Blue Cross or BCN to provide behavioral health services
• Have a doctoral degree in psychology (Ph.D., Ed.D. or Psy.D.)
• Have a full license to practice psychology in the state of Michigan
• Have education, training and experience in providing ABA services

Submit an attestation form
Psychologists who believe they qualify for ABA reimbursement must complete a form stating that they have educational background, training and experience in providing ABA services.

Access this form as follows:

• On the Blue Cross Autism page within Provider Secured Services:
1. Go to bcbsm.com/providers.
2. Click on Login.
3. Log in to Provider Secured Services.
4. Click on BCBSM Provider Publications and Resources, at the right.
5. Click on Newsletter & Resources
6. Click on Clinical Criteria & Resources.
7. Click on Autism (in the Resources section).
8. Look under the Autism provider resource materials heading.
• On BCN’s Autism webpage at ereferrals.bcbsm.com. Look under the Autism provider resource materials heading.
• On BCN’s Autism page within Provider Secured Services:
1. Visit bcbsm.com/providers.
2. Click on Login.
3. Log in to Provider Secured Services.
4. Click on BCN Provider Publications and Resources at the right.
5. Click on Autism.
6. Look under the Autism provider resource materials heading.

Complete the form and follow the instructions on the form to submit it.

We’ll notify each psychologist by email as to whether he or she can bill for ABA services.

Additional information
This applies to services for Blue Cross and BCN commercial members since it is typically these members who have autism coverage under their plans.

When billing ABA services, psychologists should use the autism billing codes along with modifier AH.

See the following documents for more information:

• Applied Behavior Analysis Billing Guidelines and Procedure Codes — You can access this document on both Blue Cross and BCN Autism pages within Provider Secured Services. Follow the directions given earlier in this article to access those webpages.
• Blue Cross fee schedule — To access this document, visit bcbsm.com/providers, click on Login, log in to Provider Secured Services using your user name and password and click on Blue Cross Provider Publications and Resources on the right side of the Provider Secured Services welcome page. Click on Newsletters & Resources, then click on Entire Fee Schedules and Fee Changes.Click on Accept, then click on either Professional Fee Schedules or Facility Fee Schedules. Locate the appropriate fee schedule and click to open it.
• BCN Behavioral health fee schedule — To access this document, visit bcbsm.com/providers, click on Login, log in to Provider Secured Services using your user name and password and click on BCN Provider Publications and Resources on the right side of the Provider Secured Services welcome page. Then click on Behavioral Health on the left and look under the General resources heading.