Which Code is Used for the Initial Behavior Assessment?
The code used for the initial behavior assessment is 97151.
According to the documentation, this specific CPT code covers the behavioral assessment conducted by a Board Certified Behavior Analyst (BCBA) to establish a child’s baseline and create their initial treatment plan.
Key details regarding this code include:
- Purpose: It is used for both the initial assessment and ongoing treatment planning evaluations.
- Documentation: The use of this code must be supported by robust clinical documentation to satisfy insurance requirements.
- Telehealth: If the assessment is conducted via synchronous video or interactive audio/video, it may require specific modifiers such as 95 or GT.
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