Hippa Compliant
Instagram Linkedin

ABA Therapy Billing Services for Clinics and Behavior Analysts

Medical Billing Solutions for Your ABA Practice – EZE Medical Billing Services

ABA Therapy Billing Services

Helping ABA Therapists Simplify Billing and Stay Updated

At EZE Medical Billing Services, we offer trusted billing support for ABA therapy practices. We understand how important it is to stay updated with changing insurance rules, billing needs, and reimbursement rates. That’s why we provide customized billing services made just for ABA therapists.

We know that following insurance guidelines and adjusting to industry updates can be stressful. Our experienced team keeps track of Medicaid policies, copays, deductibles, and private insurance changes so you don’t have to. This allows you to focus more on your patients and less on paperwork.

When you work with EZE Medical Billing Services, you get more than just billing support. You gain a dedicated partner who understands the unique needs of behavioral health providers. While our team handles the billing process, your therapists and clinicians can fully focus on helping individuals with behavioral and mental health challenges live better lives.

Understanding and Tackling with EZE Medical Billing Services

Managing billing for ABA therapy can be challenging. At EZE Medical Billing Services, we help you handle these complexities so your practice runs smoothly and your focus stays on patient care.

Complex Insurance Processes

Dealing with insurance rules, getting approvals, and understanding what is covered takes a lot of time and effort.

Authorization and Pre-Approvals

Delays in getting prior authorizations from insurance providers can interrupt a patient’s care schedule.

Detailed Documentation Needs

You must keep accurate records such as treatment plans, progress notes, and session details to meet insurance requirements.

Timely Claim Submissions

Sending claims to insurance companies on time is key to avoiding payment delays and improving cash flow.

Changing Regulations

To stay compliant and financially stable, you need to stay updated with policy changes and new billing rules.

Reimbursement Rate Discussions

Working out fair payment rates with insurance companies can be difficult and time-consuming.

Handling Appeals

Knowing how to manage denied claims and submit the right documents for appeals is an important part of the billing process.

Using Billing Technology

Setting up and maintaining billing software and EHR systems can be complicated without the right support.

Working with EZE Medical Billing Services

Partnering with EZE Medical Billing Services helps improve efficiency, reduce billing mistakes, and boost financial results for ABA therapy practices.

Staff Learning and Development

It’s important to provide ongoing training to billing teams and ABA providers so they stay updated with the latest billing guidelines and best practices.

ABA Billing Services in New Mexico - Accurate, Compliant & Hassle-Free

Claim Accuracy Rate

First-Pass Acceptance

Denied Claim Recovery

ABA Billing Solutions

How We Can Keep Your ABA Clinics Going – EZE Medical Billing Services

  • Expert Billing Strategies to Maximize Your Reimbursements

  • Dedicated ABA Billing Solutions for Improved Payouts

  • In‑Depth Knowledge of ABA Billing Rules and Payer Guidelines

  • Accurate Claims with Pristine Submission Standards

  • Thorough Post‑Billing Reviews to Ensure Claim Integrity

  • Lower Denial Rates by Meeting All Insurance Requirements

  • Reduced Overhead through Streamlined Billing Processes

  • Outsourced Billing Expertise to Cut Costs and Boost Revenue

  • Full Client Portal Access plus a Free EMR Evaluation for Enhanced Practice Performance

ABA Codes We Bill Every Day

ABA services are billed in 15 minute units, and each code depends on who delivers the service and how. A wrong code or rendering provider is one of the most common reasons ABA claims are denied or underpaid.

ServiceCode
Behavior identification assessment by a behavior analyst97151
Supporting assessment by a technician97152
Adaptive behavior treatment by protocol (technician)97153
Group treatment by protocol97154
Treatment with protocol modification (behavior analyst)97155
Family adaptive behavior treatment guidance97156
Multiple family group guidance97157
Group treatment with protocol modification97158

Authorizations and Unit Tracking

Most payers approve ABA in a set number of units per code for a fixed period. We track approved units against scheduled sessions every week, alert you before authorizations run low and submit reauthorization requests with updated treatment plans on time. Your clients keep receiving care and your team never delivers hours that cannot be billed.

Credentials and Supervision

Payers look closely at who delivered each session. We match every claim to the right rendering provider and credential level, whether the service was delivered by a BCBA, a BCaBA or a behavior technician, and we monitor supervision hours so your documentation supports every unit billed.

ABA Billing for New Mexico Medicaid

New Mexico runs one of the most structured ABA programs in the country, and it rewards agencies that bill it correctly.

  • ABA is delivered in three stages: evaluation, assessment and treatment. Stage 1 evaluations use T1026 with specific modifiers, while assessments and treatment use the ABA CPT codes.
  • Stage 2 and Stage 3 services require prior authorization. Stage 3 treatment needs authorization before services start and again every six months.
  • Rates are tiered by credential. The same 97153 or 97155 unit pays differently depending on who delivers it, so every claim must carry the right credential information.
  • ABA is covered for Medicaid enrolled adults as well as children, with defined service authorization periods for each age group.

We handle these rules for all four Turquoise Care plans and fee for service Medicaid, so New Mexico ABA agencies get paid the full rate they have earned.

Part of Our Behavioral Health Billing

ABA is one part of our wider mental health billing services, so agencies that also offer therapy or psychiatric care can keep all their billing with one team.

Get in Touch

Let’s Talk About Your Billing Needs

Fill out the form below and our team will contact you shortly.
Get a Free Medical Billing Consultation New Mexico

Frequently Asked Questions

Which CPT codes are used for ABA billing?

ABA services use codes 97151 to 97158. The most common are 97151 for assessments by a behavior analyst, 97153 for treatment delivered by a technician and 97155 for treatment with protocol changes by a behavior analyst. Each code is billed in 15 minute units.
Most ABA codes are billed per 15 minutes of service. Payers apply different rounding rules for partial units, so we follow each payer’s policy and check session times against units before every claim goes out.
Yes. We compare approved units with scheduled and delivered sessions every week, alert you before an authorization runs low and submit reauthorization requests on time.
Yes. We bill services delivered by each credential level and make sure the rendering provider, supervision and documentation on every claim match payer requirements.
Yes. New Mexico Medicaid covers ABA for eligible children under the EPSDT benefit and also for Medicaid enrolled adults with a documented autism spectrum disorder diagnosis.
New Mexico Medicaid uses a three stage model. Stage 2 assessments and Stage 3 treatment require prior authorization, and Stage 3 treatment must be reauthorized every six months. We prepare and track every request for you.
New Mexico Medicaid pays ABA on a tiered fee schedule based on the credential of the person delivering the service. Billing the right credential level on every claim makes sure your agency receives the full rate for each unit.