Instant verification
See the full benefit breakdown in seconds, with coverage across 1,800+ payers, so a family hears whether ABA is covered on the first call instead of waiting on a callback.
Insurance Verification for ABA Therapy Providers
Know ABA Is Covered Before Services Start
When a family calls about ABA therapy for their child, your intake team needs to know the plan covers it before you schedule an assessment. VerifyTreatment returns benefits in seconds, flags plans that route behavioral health to a separate administrator, and re-verifies every active client so a lapse never surfaces months into treatment.
ABA Benefits, Under the Service Types Payers Actually Use
There is no service type for ABA in a standard eligibility check, so a plan that covers ABA can look like it doesn’t. VerifyTreatment checks the service types payers use to return ABA benefits, so your team sees what applies to the codes you bill.
| ABA services | CPT codes | Service types checked |
|---|---|---|
| Assessment | 97151, 97152 | BD Cognitive Therapy, MH Mental Health |
| Direct treatment, individual and group | 97153, 97154 | BD Cognitive Therapy, MH Mental Health |
| Supervision and protocol changes | 97155, 97158 | BD Cognitive Therapy, MH Mental Health |
| Family and caregiver guidance | 97156, 97157 | BD Cognitive Therapy, MH Mental Health |
HIPAA 5010 has no ABA service type, so payers most often return ABA benefits under Cognitive Therapy or Mental Health. Results are as detailed as the payer returns. Deductibles, copays, coinsurance, visit limits and prior authorization requirements appear when the payer includes them.
What Your Intake and Billing Teams Get
Carve-out handling
When a plan routes behavioral health benefits to a separate administrator, your team sees the flag and re-runs the check under the carve-out payer in one click.
Caseload re-verification
ABA runs for months. Re-verify your active caseload on a schedule and get an alert when a policy lapses or terminates, before sessions continue on coverage that has ended.
Insurance discovery
When a family isn’t sure what they have, start from what they know and find their primary and secondary coverage.
Payer alerts
Note which plans need authorization, limit hours or route ABA to another administrator, so every coordinator gives the same answer for the same plan.
Intake webforms
Verify insurance from your website’s intake form around the clock, so benefits are waiting when your team calls the family back.
- verifications run
- 11 million+
- lapses in coverage identified
- 550,000+
- verifications rerouted to a carve-out payer
- 24,000+
- Coverage Discovery hit rate, and climbing
- 65%
30,000+ active users at organizations like these.
Trusted by Healthcare Professionals
We verify our census at least once a week, and catch a minimum of one termed policy each time with VerifyTX. That translates to several thousands of dollars a week saved.
MATT HIRSCHExecutive VPYou don’t have to log into 10 different portals anymore. Verify saves time, saves money, and makes the data usable across departments. We’ve never had visibility like this before.
BRIAN MENDOZATherapist, Lifestance HealthThe product is lightning fast, and so easy to use. In terms of instant verification, there is nothing faster or more comprehensive in my experience. Highly recommend for billing/admissions departments.
MATT WALDENBusiness DevelopmentFrequently Asked Questions
Can VerifyTreatment verify insurance benefits for ABA therapy?
Yes. VerifyTreatment checks the service types payers use to return ABA benefits, including Cognitive Therapy and Mental Health, so your team sees the benefits that apply to ABA codes. Results are as detailed as the payer’s response.
Why does ABA sometimes look uncovered in an eligibility check?
The HIPAA 5010 eligibility standard has no service type for ABA. A check that only asks about general medical benefits can miss ABA coverage that the payer returns under Cognitive Therapy or Mental Health.
Does VerifyTreatment show whether ABA needs prior authorization?
VerifyTreatment shows prior authorization requirements when the payer includes them in its response, along with visit limits and cost-sharing details. It doesn’t submit authorization requests.
How does VerifyTreatment handle plans that carve out behavioral health?
When a plan routes behavioral health benefits to a separate administrator, VerifyTreatment flags the carve-out and lets you re-run the check under that payer in one click, so you see the benefits that apply to your services.
Can we re-verify clients who are already receiving ABA services?
Yes. Auto-VOB re-verifies your active caseload on a schedule and alerts your team when a policy lapses or terminates. Each re-check uses one VOB credit from your plan.
Can VerifyTreatment find a client’s secondary insurance?
Yes. Insurance discovery finds a client’s primary and secondary coverage from the details the family knows, including Medicaid behind a commercial plan.
Does VerifyTreatment tell us what the family will owe?
VerifyTreatment gives you the deductible, copay, coinsurance and out-of-pocket details your team needs to calculate patient responsibility. The calculation itself stays with your team.
How do we find a BCBA’s or RBT’s NPI number?
Search any provider by name, NPI or specialty in the free NPI Lookup, which shows their NPI, taxonomy and practice location.
Is VerifyTX HIPAA compliant?
Absolutely. Given the sensitive nature of our business, we take HIPAA compliance and security seriously. VerifyTX uses SSL 128-bit encryption, and your data is treated with bank-level security, encrypted at all times and regularly backed up. All users agree to our business associate agreement when using the service.
What is implementation like?
Your team can start the same day: going live needs your NPI, Tax ID and a payment method, with no IT project. If you want results inside your practice management software or on your website, the API is included on every plan.
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See how your intake team verifies ABA benefits, catches carve-outs and keeps every active client covered.