Top 3 Differences Billing Speech Therapy vs ABA
Jonathan Mueller
Founder & Co-CEO, Element RCM & Ascend Behavior Partners | Passionate about value-based care in the autism services field | Building authentic relationships in the process
I'm honored to share this guest post from Element's VP Revenue Cycle Management, Ryan Gilliam.
When most Applied Behavior Analysis (ABA) practices think about an interdisciplinary model for supporting their children, they often believe that the first service to add is speech therapy. Why not? Board Certified Behavior Analysts (BCBAs) and Speech-Language Pathologists (SLPs) usually work closely together on cases. It makes sense that an ABA practice would hire an SLP and bill for speech services.?
Top 3 Differences Between ABA & Speech Billing
Billing often varies for different provider specialties (for both insurance and Medicaid). Here are three for ABA/Speech:
1.Timed vs. Untimed: ABA CPT codes are generally timed (eg 15 minutes per unit of 97153), while most SLP CPT codes are untimed.
Why it matters:?most SLP codes can only be billed once per date of service, no matter how long the speech therapy session lasts.
2. # of CPT Codes: most ABA providers use fewer than 10 Adaptive Behavior Treatment codes (eg 97151).?In contrast, SLP CPT codes lists can seem exhaustive, with providers needing to learn over 20.
Why it matters:?selecting the right CPT code to align to the right service means accurate insurance billing, fewer claims denials, and potentially fewer audits
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3. Documentation:?accurate documentation (eg session notes, SOAP notes, etc.) is crucial for any medical and behavioral health discipline. SLP is even more vital because accurate medical documentation allows an organization to select the correct CPT code for speech therapy.
Why it matters: accurate codes = faster and more accurate reimbursement
Don’t worry, here’s a resource to help!
Before you start offering speech therapy to your clients, make sure you research the?American Speech-Language-Hearing Association (ASHA). They have a wealth of information available, particularly about billing insurance for speech services.?
As always, the Element team is here to serve, strengthen, and support you in any way we can. Contact us if you’re considering adding speech therapy services and you want to learn how to bill ethically and in compliance … particularly in an interdisciplinary model.?
We are here to help! Remember, Element is not a billing company; we are your revenue cycle partner. Now be great, the world is waiting for you!
Ryan?
ps Do you have any questions? Email me anytime at?[email protected] or check us out at https://elementrcm.ai/