As we get further into 2025, Applied Behavior Analysis (ABA) therapy providers are facing a period of heightened financial uncertainty. At the center of the conversation are the proposed Medicaid cuts — federal and state-level decisions that could have lasting effects on access, reimbursement, and the operational sustainability of behavioral health services in the United […]
On the Missing Piece Blog, you can find everything you need to know about outsourcing billing services for ABA therapy.
Missing Piece has over 13 years of experience in ABA insurance billing services. Our blog is filled to the brim with essential ABA insurance billing information, such as current billing codes for occupational therapy, how to outsource medical billing, how to claim for an ABA treatment plan, and more.
Whether you want to know about the history of ABA therapy or you’re more interested in the future of medical billing in the industry, our blog has everything you need. You can also listen to the Missing Piece Podcast, one of the best ABA podcasts, for up-to-date information for anyone with an interest in the industry.
Read our most recent blogs below.
Keeping ABA Clinics Profitable in 2025
Revenue Risk in 2025: How ABA Practices Can Stay Profitable In 2025, ABA therapy practices, among many other healthcare providers, are navigating one of the most uncertain financial landscapes in recent history. Despite the demand for Applied Behavior Analysis (ABA) therapy continuing to grow, providers are now facing potential policy shifts, increased staffing shortages, and […]
Case Study: Challenging Modifier Misuse Allegations with Horizon New Jersey
Client Impact: $300,000 in Paid Claims | Resolution Time: 30 DaysKey Outcome: Pre-Payment Review Lifted | Claims Paid Within 15 Days The Challenge In 2019, the American Medical Association updated the CPT codes for ABA services, including guidance that speech therapy code 92507 should not be billed in conjunction with 97153 or 97155. However, when […]
Case Study: Holding Golden Rule Accountable in Florida and Indiana
Total Client Impact: Over $620,000 in Recovered Revenue | Two States, Two Systemic WinsKey Outcomes: Misrepresentation Corrected in FL | DOI Intervention in IN Florida: Correcting Misrepresentation and Securing Full-Year Coverage The ChallengeIn 2013, families affiliated with the Florida Institute of Technology (FIT) purchased Golden Rule insurance plans based on broker assurances that ABA therapy […]
Case Study: Correcting Systemwide Denials for CPT 0373T with Indiana Medicaid
Client Impact: $500,000 in Paid Claims | Resolution Time: 4 MonthsIndustry Impact: Statewide System Fix for All ABA Medicaid Providers The ChallengeIn Indiana, ABA providers faced a critical billing disruption when CPT 0373T—a Category III code essential for adaptive behavior treatment with protocol modification—was excluded from Indiana Medicaid’s provider-to-procedure code linkage system. This oversight resulted […]
Case Study: Bridging the Gap Between Blue Cross Blue Shield of Texas and Blue Cross Blue Shield of South Carolina
Client Impact: $350,000 in Paid Claims | Resolution Time: 1 year and 35 Days The ChallengeA provider partnered with Missing Piece ABA Billing experienced claim denials from Blue Cross Blue Shield of Texas (BCBS TX) for CPT 97153, an essential ABA therapy code. While BCBS TX requires specific modifiers on these claims, all submissions were […]
Navigating State-Specific Regulations for Behavioral Health Billing
Billing for behavioral health services is complex and time-consuming. A major factor that influences the intricacies of behavioral health medical billing is the range of state-specific regulations that govern Medicaid, licensure, documentation, and billing codes. Staying compliant with these diverse and changing rules is essential to avoid denied claims, legal risks, and underpayment. Let’s take […]
Key Metrics for Behavioral Health Billing
Running a successful behavioral health practice involves much more than providing excellent care to your clients. Behind every therapy session and treatment plan lies a complex revenue cycle management process that directly impacts your practice’s financial health. For behavioral health providers, especially those offering ABA therapy services, understanding and tracking key billing metrics is extremely […]
What is Balance Billing, and How Does it Affect Behavioral Health Services?
Balance billing is a financial hurdle that often surprises patients and complicates operations for healthcare providers, quickly turning a positive healthcare experience into a stressful financial puzzle. It can be an extremely frustrating process for patients and practices, especially within behavioral health services, largely due to misconceptions about how it works. This guide explains what […]
Telehealth Trends for Behavioral Health in 2025
Technology and innovation have been the driving forces behind improvements in healthcare for decades, improving diagnostic accuracy, treatment methods, patient outcomes, and access to care worldwide. From the development of advanced diagnostic and treatment tools to the rise of telemedicine platforms that help patients connect with healthcare providers remotely, technological advancements have transformed nearly every […]