Are Telehealth Sessions Covered under Standard Aba Billing Codes?
Yes, telehealth sessions are covered under the standard ABA billing codes, but they require specific modifications to be processed correctly.
According to the provided content, billing for telehealth involves the following requirements:
- Consistent CPT Codes: Telehealth services use the same standard Category I CPT codes as in-person sessions (such as 97151, 97153, or 97155).
- Required Modifiers: To indicate that the service was performed virtually, you must append specific modifiers to the CPT code. Use modifier 95 for synchronous video sessions or modifier GT for interactive audio/video sessions.
- Billing Units: Sessions are still billed in the standard 15-minute increments, following the same rules as in-person therapy.
- Insurance Variation: While the core coding remains the same, coverage for virtual visits varies by insurance plan. Some payers may require prior authorization for telehealth, and state autism insurance mandates can also influence specific payer policies.
It is recommended to verify benefits for your specific plan, as insurance coverage is subject to verification and is not guaranteed.
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