Billing Codes for Applied Behavior Analysis

In July 2020, Cigna adopted new CPT billing codes proposed by the American Medical Association for Applied Behavioral Analysis (ABA) treatment. Below is a list of revised billing codes that Cigna uses for autism services. It explains how the codes should be used, what provider type can provide the given service, and who can bill for the given service.

All of the ABA CPT codes are in 15-minute increments.

CODE HOW THE CODE SHOULD BE USED FOR CIGNA BEHAVIORAL HEALTH WHO CAN PROVIDE THE SERVICE? WHO CAN BILL FOR THE SERVICE?
97151 Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan. BCBA-D®,BCBA®, or licensed mental health provider BCBA-D®,BCBA®, or licensed mental health provider
0362T Exposure behavioral follow-up assessment, includes physician or other qualified provider direction with the assistance of one or more technicians. 0362T is reported based on a single technician's face-to-face time with the patient and not the combined time of multiple technicians. BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider
97155 Adaptive behavior treatment with protocol modification, administered by physician or other qualified healthcare provider with one patient. BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider
97156 Family adaptive behavior treatment guidance, administered by physician or other qualified healthcare provider (with or without the patient present). BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider
97157 Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified healthcare provider (without the patient present). BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider
0373T Exposure adaptive behavior treatment with protocol modification, requiring two or more technicians for severe maladaptive behavior(s). 0373T is reported based on a single technician's face-to-face time with the patient and not the combined time of multiple technicians. BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider
97152 Observational behavioral follow-up assessment, includes physician or other qualified provider direction with interpretation and report, administered by one technician. BCaBA, Technician BCBA-D, BCBA, or licensed mental health provider
97153 Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient. BCaBA, Technician BCBA-D, BCBA, or licensed mental health provider
97154 Group adaptive behavior treatment by protocol, administered by technician, face-to-face with two or more patients. BCaBA, Technician BCBA-D, BCBA, or licensed mental health provider
97158 Adaptive behavior treatment social skills group, administered by physician or other qualified healthcare provider, face-to-face with multiple patients. BCBA-D, BCBA, or licensed mental health provider BCBA-D, BCBA, or licensed mental health provider