Proposed New Hampshire Medicaid Changes to Applied Behavior Analysis Services Codes: A Webinar for Providers
July 21, 2025 -- 12:00- 1:30 pm
Presenters: Gina Green and Jenna Minton, ABA Coding Coalition
In late June the New Hampshire Medicaid Program announced that it is proposing to change its policies on the use of Current Procedural Terminology® (CPT®) codes 97153, 97154, and 97155 for applied behavior analysis (ABA) services. The proposed changes will appear in a State Plan Amendment (SPA) to be submitted to the Centers for Medicare & Medicaid Services. Public comments on the SPA must be submitted by August 15. In this webinar, two consultants to the ABA Coding Coalition and co-authors of the CPT codes for ABA services will offerinformation to help New Hampshire ABA Medicaid providers understand and respond to the proposed changes. Topics will include
• Differences between direct (billable) and indirect (generally non-billable) services in the context of CPT codes
• Appropriate uses of codes 97153, 97154, and 97155 as intended by the code authors and issued by the American Medical Association CPT Editorial Panel
• For code 97155, services encompassed by “protocol modification” and “direction of technician,” including key differences between the latter and “supervision”
• Sources of guidance for determining appropriate utilization of codes 97153 and 97154
• Implications for changes proposed by NH Medicaid
