Effective August 1st, 2021, NYSDOH covers ABA services for certain plans if performed by specifically licensed specialists. To know who can now receive reimbursement for this service, read along!
From August 1st, 2021 NY State Medicaid fee-for-service and from October 1st, 2021 – Medicaid Managed Care Plans cover Applied Behavior Analysis (ABA) services when provided by the following specialists:
• NYS Medicaid enrolled Licensed Behavior Analysts
• Certified Behavior Analyst Assistants or other individuals specified under Article 167 of NYS Education Law working under the supervision of LBAs.
The following CPT codes must be reported for ABA services:
• When performed by a physician or other healthcare professional directly: 97151, 97155
• When performed by a technician under physician supervision: 97152, 97153
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