ABA Billing & RCM Services
Billing built for how ABA actually works.
Authorizations tracked by client, units billed in 15-minute increments, supervision and credential rules that change by payer and state. We run ABA billing end to end inside your EHR, or take on just the parts you need. Flat-fee pricing available.
- ABA-specialized team
- Medicaid & commercial payers
- 2027 code transition handled
Effective January 1, 2027
The ABA code set changes in 61 days
6 new codes
97148, 97149, 97159, 97160, 97173, 97180
97155 splits
Direct BCBA treatment moves to 97173
2 codes deleted
0362T and 0373T, after Dec 31, 2026
Existing codes reworded
Note templates need to match the new wording
Each payer sets its own rule for moving authorizations with 97155, 0362T or 0373T to the new codes. Know every payer’s rule before January.
2027 CPT changes
Not ready for January 1? Your January claims pay the price.
Every ABA practice has to switch codes on the same day. The ones that wait find out from their denials.
In short: on January 1, 2027, the ABA (adaptive behavior) CPT code set grows from 10 codes to 14. Six codes are added (97148, 97149, 97159, 97160, 97173 and 97180). 97155 now covers only a BCBA directing a technician; direct BCBA treatment moves to 97173. Several existing codes are reworded, and the Category III codes 0362T and 0373T are deleted after December 31, 2026, replaced by the new harmful-behavior codes.
BCBA time billed to the wrong code
From January 1, direct BCBA treatment is 97173, not 97155. Billing it the old way is a coding error that can clash with your authorizations and show up in an audit. This affects almost every practice.
Authorizations that cross January 1
Each payer decides how existing auths with 97155, 0362T or 0373T move to the new codes: it may convert them, allow a transition period, or require a new request. Miss a payer’s rule and sessions can go unauthorized.
Severe-behavior services on deleted codes
Claims follow the date of service: 2026 sessions keep 0362T and 0373T even if billed in January. 2027 sessions need 97148, 97149, 97159 or 97160, unless your payer says otherwise.
See all 2027 code changes
Change
Codes
What it covers
New
97148 · +97149
Assessment of harmful behavior: two technicians, with the BCBA on site. +97149 adds the 3rd to 5th technician.
New
97159 · +97160
Treatment of harmful behavior under the same conditions. +97160 adds the 3rd to 5th technician.
New
97173
BCBA treating one client directly, face to face, with analysis.
New
97180
BCBA work without the client present, such as data review and protocol changes.
Revised
97155
Now the BCBA directing a technician, with analysis, face to face.
Reworded
97152–97154 97156–97158
Technician codes drop “under the direction of”; 97156–97158 add “with analysis”. Note templates should match.
Deleted
0362T · 0373T
Valid through December 31, 2026. Some payers stopped accepting them earlier.
Based on the 2027 CPT code set released by the AMA on September 9, 2026, as summarized by the ABA Coding Coalition. Payer coverage, rates and authorization rules are set by each payer.
Before January 1
2027 Code-Readiness Review
We find what the code change puts at risk in your practice, and fix it before your first 2027 claim.
- Every authorization that crosses January 1, with each payer’s transition rule and the action needed
- Your 97155 vs 97173 exposure, by BCBA
- Severe-behavior services mapped from 0362T / 0373T to the new codes
- EHR and note-template changes, in a checklist your team can follow
- Your findings also set the baseline for performance targets we agree in writing.
Included
in the $499 Audit-Readiness Check, which can be credited toward full RCM
How we handle it
From session to payment, every step checked
01
Benefits & authorizations
ABA benefits and carve-outs verified, auths tracked by client with alerts before units or dates run out.
02
Claim scrubbing
Every claim checked before it goes out: units, codes, modifiers, rendering provider and credentials, against the session note, the auth and the payer’s rules.
03
Submission & tracking
Clean claims sent electronically and tracked until the payer accepts them, so rejections are fixed before they age.
04
Payment posting
ERAs posted and reconciled, with underpayments flagged against your contracted rates.
05
Denials & appeals
Root cause fixed, claim resubmitted, and medical-necessity appeals written when needed.
06
AR & audit readiness
Every open claim worked by dollar value and filing deadline, and notes kept ready for a records request.
Common ABA denials
Why ABA claims get denied, and how we stop it
Change
Usual cause
How we prevent it
No authorization on file
Auth expired, not yet approved, or attached to the wrong code
Auth checked on every claim before it goes out
Units exceed authorization
Sessions keep running after approved units are used
Unit alerts by client, before the limit is hit
Rendering provider not credentialed
New RBT or BCBA billed before payer enrollment is active
Credentialing tracked so no one bills before approval
Missing or wrong modifier
Credential or telehealth modifiers left off or used incorrectly
Modifier rules set for each payer in the claim scrubber
State Medicaid rules not followed
State requirements missed, such as supervision, group size, telehealth or billing-provider rules
Each state’s ABA rules built into our checks before the first claim
Other insurance on file
Coordination of benefits not updated, so the wrong payer is billed first
Eligibility and other coverage checked before each auth period
Timely filing
Claims or corrections sent after the payer’s deadline
AR worked by filing deadline, not just by age
- Not every problem shows up as a denial. Notes that don’t support the units billed usually get paid, then taken back in an audit. Our Audit-Readiness Check finds them first.
Which of these is costing you money right now?
We’ll show you on a free 30-minute Risk Review, using your own denial and AR reports.
How to start
Start free. Go deeper when you’re ready.
- Flat-fee option
- Targets agreed in writing
- BAA before any data access
FAQ
ABA billing questions
What does an ABA billing company do?
An ABA billing company runs the revenue cycle for an ABA practice: verifying benefits, tracking authorizations by client, checking units and codes against session notes, submitting claims, posting payments, working denials and AR, and keeping documentation ready for audits. eClaimsBilling does this inside your EHR, as full RCM or individual services, with flat-fee pricing available.
What CPT codes are used for ABA therapy billing?
Through December 31, 2026, ABA is billed with CPT 97151–97158 and, where the payer covers them, the Category III codes 0362T and 0373T for severe behavior. From January 1, 2027, the set has 14 codes: 97151–97158, several with revised wording, plus new codes 97148, 97149, 97159, 97160, 97173 and 97180. 0362T and 0373T are deleted.
Do our current authorizations carry over to the 2027 codes?
It depends on the payer. Authorizations name specific codes, so each payer decides how authorizations that cross January 1, 2027 and include 97155, 0362T or 0373T move to the new codes: some may convert them, allow a transition period, or ask for a new request. Get each payer’s rule in writing. Claims follow the date of service, so 2026 sessions keep their 2026 codes even if billed in 2027. We handle this for our clients before the change.
Can 97153 and 97155 be billed for the same time?
Some payers allow it when the BCBA is directing the technician during the session; others don’t. We set concurrent-billing rules for each payer so claims follow that payer’s policy.
Do you bill both Medicaid and commercial insurance for ABA?
Yes. We bill Medicaid, including managed care plans, and commercial insurance, and apply each plan’s ABA rules for authorizations, modifiers and telehealth.
How is your ABA billing priced?
We price full RCM and individual services as either a flat monthly fee or a percentage of collections, depending on your practice and the services you need. We quote after a free Risk Review, based on your claim volume. A flat fee keeps your bill steady when collections grow. The $499 Audit-Readiness Check can be credited toward full RCM.
Free ABA Billing Risk Review
30 minutes with a senior specialist. No obligation. You leave with your top billing risks and your 2027 code exposure.
Let's talk
Find your billing risks
before a payer does
Book your free 30-minute ABA Billing Risk Review. We'll flag your top risks and recommend the right starting point. Send us a denial summary by reason and payer before the call (no patient names), and we'll bring a one-page heatmap of where your denials come from.
A call back within 1 business hour
Mon–Fri, 8am–6pm ET
BAA before any data access
Nothing shared on the first call
ABA-specific
We speak 97153, not generic medical billing
Book your free Risk Review
No patient data needed. We’ll send times that work for you.
