KMAP BULLETIN: Autism Codes - CCTS/IIS Coverage
Date: 06/24/24
KMAP GENERAL BULLETIN 24125 (PDF)
Effective with dates of service on and after July 1, 2024, Consultative Clinical and Therapeutic Services (CCTS) Provider Type/Provider Specialty (PT/PS) 11/403 can bill the following procedure codes:
| Procedure Code |
|---|
| 97153 |
| 97154 |
| 97158 |
Intensive Individual Supports (IIS) (11/404) can bill code 97154. Procedure code 97153 will continue to be covered for IIS PT/PS 11/404.
Service Rate Increase for Code 97153:
Effective with dates of service on and after July 1, 2024, the service rate for code 97153 will be increased for applied behavioral analysis to $65/hour ($16.25 per unit, 15 minutes).
Note: The effective date of the policy is July 1, 2024. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the KMAP bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.
For the changes resulting from this provider bulletin, view the updated Mental Health Fee-for-Service Provider Manual, Section 8400, page 8-6 – 8-7; and Professional Fee-for-Service Manual, Section 8400, pages 8-13 – 8-14.