Current Procedural Terminology (CPT) codes undergo regular changes so that all healthcare professionals, including ABA practitioners, have a standardized system to work from. However, staying up-to-date on all the latest coding changes can be difficult, which can negatively impact an ABA practitioner’s billing if they accidentally use a wrong or outdated CPT code for ABA therapy.
Here, we briefly examine what you need to know about CPT codes and the new ABA therapy CPT codes for 2024. By ensuring you know the latest updates to the ABA CPT codes for 2024, you’ll be able to provide more accurate and efficient ABA therapy billing moving forward.
Understanding CPT codes for ABA therapy
The American Medical Association (AMA) is the organization that ensures CPT codes are reflective of the current healthcare environment, with CPT codes undergoing regular changes as a result. These changes are implemented and maintained by the CPT Editorial Panel, a body that consists of 21 expert volunteers from different areas of the healthcare industry.
There are four CPT code categories in total, but only two are applicable to ABA therapy practices. These are:
- Category I: This is a category of CPT codes for widely used medical procedures or services.
- Category III: This is a category of CPT codes for new or emerging medical technologies, procedures, or services. Due to how new these are, they are not widely used.
All CPT codes consist of five characters, although the composition of these codes varies depending on the category, with some categories using only numbers while others use a combination of numbers and letters. The characters in an ABA therapy CPT code don’t have any direct association with a procedure, technology, or service, but they are assigned to them to make it easier for healthcare professionals to track.
New ABA CPT codes for 2024
Now that you have a better understanding of the basic systems behind CPT codes, here are the latest CPT codes for ABA therapy used for adaptive behavior assessment and adaptive behavior treatment.
Adaptive Behavior Assessment
| CPT Code | Description |
| 97151 | Behavior identification assessment performed by a physician or other qualified healthcare professional. This can be face-to-face time with a patient and/or guardian(s) and/or caregiver(s) when administering assessments or reviewing findings or recommendations. It can also include non-face-to-face time spent assessing past data, scoring or interpreting an assessment, and preparing a report or treatment plan. The time counted is every 15 minutes. |
| 97152 | Behavior identification supporting assessment performed by one technician. This technician is also under the direction of a physician or other qualified healthcare professional. This assessment is done face-to-face. The time counted is every 15 minutes. |
| 0362T | Behavior identification supporting assessment performed by a technician. It also includes administration by a physician or other qualified healthcare professional on-site, with the help of two or more technicians, for a patient who has shown destructive behavior. The assessment is done face-to-face in a space that caters to the patient’s behavior. The time counted is every 15 minutes. |
Adaptive Behavior Treatment
| CPT Code | Description |
| 97153 | Protocol adaptive behavior treatment performed by a technician. The technician is also under the direction of a physician or other qualified healthcare professional. This treatment is done face-to-face with a single patient. The time counted is every 15 minutes. |
| 97154 | Group adaptive behavior treatment by protocol performed by a technician. The technician is also under the direction of a physician or other qualified healthcare professional. This treatment is done face-to-face with two or more patients. The time counted is every 15 minutes. |
| 97155 | Adaptive behavior treatment with protocol modification performed by a physician or other qualified healthcare professional. This may include the simultaneous direction of a technician. This treatment is done face-to-face with a single patient. The time counted is every 15 minutes. |
| 97156 | Family adaptive behavior treatment with protocol modification. This treatment is performed with or without the patient, face-to-face with a guardian(s) or a caregiver(s) by a physician or other qualified healthcare professional. The time counted is every 15 minutes. |
| 97157 | Multiple family adaptive behavior treatment with protocol modification performed by a physician or other qualified healthcare professional. This treatment is done without the patient, face-to-face with more than one group of guardians or caregivers. The time counted is every 15 minutes. |
| 97158 | Group adaptive behavior treatment with protocol modification performed by a physician or other qualified healthcare professional. This treatment is done face-to-face with multiple patients. The time counted is every 15 minutes. |
| 0373T | Adaptive behavior treatment with protocol modification performed by a technician. This treatment is done face-to-face with a single patient. The time counted is every 15 minutes. |
Simplify billing and CPT code changes with Missing Piece
Regular CPT code changes for ABA therapy billing can be difficult to navigate, with the American Medical Association announcing changes that can complicate your ABA therapy billing. However, you can make your billing process easier by partnering with a dedicated ABA therapy billing provider, Missing Piece.
Missing Piece provides ABA billing services, backed by more than 10 years of experience, to ABA therapy practices across the US. Our ABA billing experts provide you with in-depth knowledge of CPT codes and billing practices that ensure billing and reimbursement processes are optimized, ensuring additional financial resources are available when needed, and can also adapt to the needs of your practice as it grows.
Contact us to learn more about how Missing Piece’s services can help your ABA therapy practice.