Behavior Analysis Billing Workshop

Our 3-hour interactive workshop is designed to give you and your team the knowledge, tools, and confidence to manage your ABA billing process accurately, efficiently, and in full compliance with payer requirements. Whether you’re new to ABA billing or looking to sharpen your existing workflow, this intensive workshop will help you strengthen your revenue cycle and reduce costly errors.

Led by an AMBA-certified CMRS, CBCO, and AAPC Credentialing Specialist with years of hands-on ABA billing experience, the training combines technical guidance with practical strategies you can implement immediately.

Workshop Highlights:

Live walkthrough of claim submission on Availity – step-by-step to submit clean claims, track submissions, and avoid common errors.
Field-by-field guidance for completing the CMS-1500 form to meet payor-specific requirements.
Editable billing form templates you can plug into your day-to-day process.
Editable ABA Billing & Reimbursement Handbook (22 pages) covering CPT codes, modifiers, billing workflows, and reimbursement tips.
7-day post-workshop email Q&A support to help you apply your new skills.

This workshop is perfect for ABA billers, practice managers, and providers who want to ensure accurate claim submissions, reduce denials, and improve cash flow. You’ll walk away with both the technical know-how and practical tools to optimize your billing process.

Why Choose This Workshop?

Unlike more generic billing programs, our workshop focuses specifically on ABA therapy billing, with real-world, payor-specific guidance tailored to your needs. We place a strong emphasis on Florida Medicaid and its managed care plans (including Sunshine Health, Community Care Plan, and Carelon Behavioral Health / Simply Healthcare), as well as major commercial payors such as Aetna, Cigna/Evernorth, Florida Blue (Lucet), Optum/UnitedHealthcare, and TRICARE.

By the end of this workshop, you’ll have a clear, actionable understanding of how to correctly bill for services across payors, avoid costly denials, and improve your agency’s cash-flow and reduce administrative burden.

Workshop Agenda

1. Introduction & Overview

Welcome and trainer introduction
Quick disclaimer on payor policy variations.

2. ABA Therapy Billing Codes

Overview of Adaptive Behavior Assessment & Treatment CPT codes (97151–97158, 0362T, 0373T).
Understanding and applying modifiers (HN, HM, HO, HP, TS, XP, GT, Medicaid-specific).
Code cheatsheet (Frequency codes, POS codes, taxonomy codes, and CMS 1500 qualifiers)
Telehealth Practices
Code Limitations

3. Fundamentals of ABA Claims

Insurance verification and prior authorization process.
Commercial vs. Medicaid/Managed Care Billing differences.
Understanding provider roles (billing, rendering, supervising, referring).
Claim submission workflows through payor portals and clearinghouses.
Payment posting and AR best practices.
Managing client financial responsibility in compliance with the No Surprises Act.
Waiving Cost-Sharing Do's and Don'ts (Copays, coinsurances, and deductibles).
Timely filing requirements.

4. Denials, Appeals, and MUEs

Common denial reasons and prevention strategies.
Corrected claims vs. appeals.
Medically Unlikely Edits (MUEs).

5. Compliance in ABA Billing

Key healthcare laws for ABA billers: False Claims Act, Anti-Kickback Statute, Balance Billing Rules, No Surprises Act.
Proactive compliance approach and internal audit tips.

6. Claim Submission Walkthrough

Availity Claim Submission: step-by-step live demo.
CMS-1500 Form: field-by-field completion guidance.

8. Resources & Support

Editable Billing Forms Templates
Editable ABA Billing & Reimbursement Policy Handbook (22 pages).
7-Day Post-Training Email Q&A Support for continued guidance.