![]() Many insurance companies will require medical necessity for this code. This code is typically not requested, as it is often not needed. How many units? It's a category 1 code, so it is billed in 15 minute units (1 hour equals 4 units). Who administers it? Registered line technicians approved by your payer (RBTs, RLTs, etc.) You will also need to provide goals that justify the number of hours / units that you intend on requesting following the assessment. In addition, you will need to provide a report of your findings, typically including and FBA or FA. How is this code documented? Whoever is running the session should have some sort of datasheet with dates, times, locations, services, and signatures (parent, BCBA) included each time there is a session. What services does this code include? It includes direct observation with the client or guardians, administering assessments (VBMAPP, ABLLS, AFLS, PEAK, etc.), discussing findings / recommendations, analyzing data, scoring or interpreting results, preparing report, and writing report.Ĭan this code be billed concurrently? Yes, with 97152 or with 97153. You will typically need to provide medical necessity to get more. Most insurance companies will approve a flat 4 hours of assessment. Who administers it? A BCBA or other QHCP. ![]()
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