Fillable Printable Bcba Stakeholder Communication Final06162016
Fillable Printable Bcba Stakeholder Communication Final06162016
Bcba Stakeholder Communication Final06162016
Douglas A. Ducey, Governor
Thomas J. Betlach, Director
801 East Jefferson, Phoenix, AZ 85034 •PO Box 25520, Phoenix, AZ 85002 •
602-417-4000 •
www.azahcccs.gov
Notification to Stakeholders: Provider Registration Requirements for licensed
Board Certified Behavior Analysts (BCBAs)
Overview
The Arizona Health Care Cost Containment System (AHCCCS) is now accepting applications from licensed
Board Certified Behavior Analysts (BCBAs). This new AHCCCS provider type will be effective October 1,
2016 and will be designated as BC in the AHCCCS Provider Registration system.
AHCCCS has finalized the code set to be linked to the new AHCCCS provider type for BCBAs as attached.
BCBAs will have a dual code set that includes traditional codes and the Category III codes (T Codes).
Provider Registration and Other Requirements
1.BCBAs currently providing services through AHCCCS-registered providers
Licensed and credentialed BCBAs who are currently working under an AHCCCS-registered
provider through a contract with an AHCCCS Managed Care Organization (MCO) will need to
submit a provider registration packet no later than August 15, 2016to AHCCCS Provider
Registration. The Provider Registration application can be found at
www.azahcccs.gov/PlansProviders/CurrentProviders/packet.html. Providers willnot be able to
submit claims beginning with date of service October 1, 2016 for BCBA services unless there
is an active AHCCCS-registered BCBA provider submitted as the rendering/service provider.
Licensed BCBAs who are currently working under an AHCCCS-registered provider and providing
services through AHCCCS Fee for Service will need to submit a provider registration packet no
later than August 15, 2016 to AHCCCS Provider Registration. Providers will not be able to submit
claims beginning with date of service October 1, 2016 for BCBA services unless there isan active
AHCCCS-registered BCBA provider submitted as the rendering/service provider.
2.BCBAs not currently employed by an AHCCCS-registered provider who wish to practice
independently starting on October 1, 2016
Licensed BCBAs who wish to practice independently starting on October 1, 2016 will need to
submit a provider registration packet no later than August 15, 2016to AHCCCS Provider
Registration. The Provider Registration application can be found at
www.azahcccs.gov/PlansProviders/CurrentProviders/packet.html. In order to submit claims for
AHCCCS Fee for Service programs, an active unrestricted license in the state of Arizona and an
active AHCCCS provider registration number is required. In order tosubmit claims for AHCCCS
managed care programs, BCBAs will need to be credentialed and contracted with AHCCCS MCOs
in addition to being registered through AHCCCS provider registration.Credentialing
requirements for BCBAs are outlined in AHCCCS Medical Policy Manual (AMPM) Chapter 900.
For additional questionsregarding the provider registration process please contact Angelica Quezada;
Health Program Manager II within the Provider Registration section at (602)417-4098 or
Angelica.Quezada@azahcccs.gov.Applications canbe faxed toAngelica Quezada’s attention at
(602)256-1474.
Code
Description
90791
Psychiatric diagnostic evaluation
96110
Developmental testing; limited (e.g., developmental screening test II, early language milestone screen),
with interpretation and report
97532
Development of cognitive skills to improve attention, memory, problem solving, (includes compensatory
training), direct (one-on-one) patient contact by the provider, each 15 minutes
99347
Home visit for the evaluation and management of an established patient, which requires at least 2 of
these 3 key components: a problem focused interval history; a problem focused examination;
straightforward medical decision making. Counseling and/or coordination of care with other providers or
agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's
needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 15
minutes face-to-face with the patient and/or family.
A0160
Non-emergency transport; mile - case worker or social worker
H0001
Alcohol and/or drug assessment
H0002
Behavioral health screening to determine eligibility for admission
H0004
Office, individual behavioral health counseling and therapy, per 15 minutes
H0015
Alcohol and/or Drug services: intensive outpatient (treatment program that operates at least 3 hours/day
and at least 3 days/week and is based on an individualized treatment plan), including assessment,
counseling; crisis intervention, and activity therapies or education
H0025
Behavioral health prevention education service (delivery of services with target population to affect
knowledge, attitude and/or behavior)
H0031
Mental health assessment, by non-physician
H0034
(Health promotion) medication training and support, per 15 minutes
H2011
Crisis intervention service, per 15 minutes
H2012
Supervised behavioral health day treatment, per hour up to 5 hours
H2014
Group skills training and development, per 15 minutes per person
H2015
Comprehensive community support services, supervised day program per 15 minutes, 5-10 hours
H2016
Comprehensive community support services (peer support), per diem
H2017
Psychosocial rehabilitation living skills training services, per 15 minutes
H2019
Therapeutic behavioral services day program, per 15 minutes up to 5 3/4 hours
H2020
Therapeutic behavioral services, per diem
H2025
Ongoing support to maintain employment, per 15 minutes
H2026
Ongoing support to maintain employment, per diem
H2027
Psychoeducational service (pre-job training and development), per 15 minutes
S5109
Home care training to home care client, per session (child)
S5109
Home care training to home care client, per session (adult)
S5109
Home care training to home care client, per session (adult geriatric)
S5110
Home care training, family (family support), per 15 minutes
S5151
Unskilled respite care, not hospice, per diem
T1016
Office case management by behavioral health professional, each 15 minutes
T1016
Out of office case management by behavioral health professional, each 15 minutes
T1016
Office case management, each 15 minutes
T1016
Out of office case management by BHT, each 15 minutes
T2016
Habilitation, residential, wavier, per diem
T2017
Habilitation, residential, wavier, 15 minutes
S5115
Home care training, non-family; per 15 minutes
0359T
Behavior identification assessment, by the physician or other qualified health care professional (QHCP),
face-to-face with patient and caregiver(s), includes administration of standardized and non-standardized
tests, detailed behavioral history, patient observation and caregiver interview, interpretation of test
results, discussion of findings and recommendations with the primary guardian(s)/caregiver(s), and
preparation of report
0360T
Observational behavioral follow-up assessment includes physician or other QHCP direction with
interpretation and report, administered by one technician; first 30 minutes of technician time, face-to-
face with the patient
0361T
Observational behavioral follow-up assessment includes physician or other QHCP direction with
interpretation and report, administered by one technician; each additional 30 minutes of technician time,
face-to-face with the patient (List separately in addition to code for primary service)
0362T
Exposure behavioral follow-up assessment includes physician or other QHCP direction with interpretation
and report, administered by physician or other qualified health care professional with the assistance of
one or more technicians; first 30 minutes of technician(s) time, face-to-face with the patient
0363T
Exposure behavioral follow-up assessment includes physician or other QHCP direction with interpretation
and report, administered by physician or other qualified health care professional with the assistance of
one or more technicians; each additional 30 minutes of technician(s) time, face-to-face with the patient
(List separately in addition to code for primary procedure)
0364T
Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient; first
30 minutes of technician time
0365T
Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient; each
additional 30 minutes of technician time (List separately in addition to code for primary procedure)
0366T
Group adaptive behavior treatment by protocol, administered by technician, face-to-face with two or
more patients; first 30 minutes of technician time (billed per individual participant)
0367T
Group adaptive behavior treatment by protocol, administered by technician, face-to-face with two or
more patients; each additional 30 minutes of technician time (List separately in addition to code for
primary procedure, billed per individual participant)
0368T
Adaptive behavior treatment with protocol modification, administered by physician or other QHCP with
one patient; first 30 minutes of patient face-to-face time
0369T
Adaptive behavior treatment with protocol modification, administered by physician or other QHCP with
one patient; each additional 30 minutes of patient face-to-face time (List separately in addition to code
for primary procedure)
0370T
Family adaptive behavior treatment guidance, administered by physician or other QHCP (without the
patient present, 30 minutes.)
0371T
Multiple-family group adaptive behavior treatment guidance, administered by physician or other QHCP
(without the patient present, billed per individual child, 30 minutes.)
0372T
Adaptive behavior treatment social skills group, administered by physician or other QHCP face-to-face
with multiple patients (billed per individual participant, 30 minutes)
0373T
Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for
severe maladaptive behavior(s); first 60 minutes of technicians' time, face-to-face with patient
0374T
Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for
severe maladaptive behavior(s); each additional 30 minutes of technicians' time face-to-face with patient
(List separately in addition to code for primary procedure)
