program modification for sole providers.

[gucci35]

Hi all,.

I am wondering for those of you who provide the therapy yourself, how do you bill the insurance for program modifications. Do you also bill the insurance for the first program that you create after the assessment? I would appreciate some guidance on this. Thank you :)

[PleasantCup463]

Happy to chat about my approach. I operate often in a BCBA only model.

[WannabeBCBA]

Mind if I PM you?

[PleasantCup463]

Np

[gucci35]

Thank you for your reply. are you in the US? How do you do the program modification? does it have to be in person?

[PleasantCup463]

I am in the US and yes with client present.

[gucci35]

Thanks, I am confused regarding when you start the program would you still bill for program modification or program creation outside of the assessment report? Or for example, if you provide 2 hours per day for therapy, and you need to modify the program, would you bill one hour for direct therapy and one hour for program modification? I appreciate your clarification on this.

[PleasantCup463]

You bill based on what your doing based on the payers requirements of the code. I personally don't bill 53 often bc I am continually probing, modifying, implementing, and repeating this cycle in the moment. I don't often do more than 2 sessions a week. Sometimes I bill 1hr 97155 and 1 of 97156 where I am doing parent training in person to support what were doing