This
notice informs billing providers of recent Medicaid billing changes directed at
Applied Behavior Analysis (ABA) services, which have affected the
billing of Early Intervention (EI) Special Instruction (SI) claims. These
changes took effect on March 3, 2025, impacting claims submitted on or after
this date. More details can be found here: https://health.ny.gov/health_care/medicaid/program/update/2024/no13_2024-12.htm#ABA.
Following
this billing change, EI SI claims containing procedure or diagnosis codes
identified in the ABA-related billing updates are denied with code CO16/N55.
Impacted
claims will appear in the Billing Provider’s workable queue in the Billing
module, but no action can be taken at this time. The Bureau of Early
Intervention (BEI) is working with Medicaid, and further instructions will be
provided.
Article ID: 547, Created On: 3/31/2025, Modified: 3/31/2025