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97155 Service Type Codes to Send

CPT code

ABA therapy with plan changes by the analyst

Why these codes

HIPAA 5010 has no ABA code. Most payers carry ABA under the mental health benefit (autism mandates sit there); some answer under cognitive therapy, a few only under medical care.

If a payer returns nothing

Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.

Sources

X12 HIPAA 5010 service type code definitions; VerifyTX billing practice

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