Missing Piece Blog

Medicaid Cuts & ABA Care in 2025: What Providers Should Prepare For Now

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 […]

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 […]