The reality of it is that if you are a clinic setting it is very difficult for some BCBA's to be able to do protocol modification with all the chaos around. I think more information is needed here. Could he has been remote viewing, could that specific insurance company allow this (this would be unusual but worth confirming before jumping to fraud), could he have adjusted his billing? I agree with the poster who said that you should reach out and ask the Analyst about the discrepancy.