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Provider Updates on ABA for Autism Spectrum Disorder (ASD) Services

Provider Updates on ABA for Autism Spectrum Disorder (ASD) Services

Effective with dates of service on and after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the applied behavior analysis (ABA) fee schedule and the policy manual for autism spectrum disorder (ASD) services.

The rate for codes 0364T and 0365T will increase to $15.50 per unit. Providers will no longer utilize procedure codes 0360T, 0361T, 0362T and 0363T for billing and reimbursement of ABA services.

SCDHHS will continue to utilize the following procedure codes for ABA reimbursement:

  • 0359T: Behavior Identification Assessment
  • 0364T-0365T: Adaptive Behavior Treatment by Protocol
  • 0368T-0369T: Adaptive Behavior Treatment with Protocol Modification
  • 0370T: Family Adaptive Behavior Treatment Guidance

For more information, please refer to the Autism Spectrum Disorder (ASD) Services Provider Manual at https://www.scdhhs.gov/provider-manual-list. For questions regarding this bulletin, please contact the SCDHHS Autism Services Program at autism@scdhhs.gov or (803) 898-2136.

Thank you for your continued support of the South Carolina Health Connections Medicaid program.

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