MedicaidAdministrativeMedium impact
Applied Behavioral Health Analysis (ABA) Billing - System Update
Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Provider Notice
Effective date
Oct 28, 2022
We identified it
Jun 20, 2026
Summary
MO HealthNet Division fixed a system issue that was incorrectly denying ABA claims for CPT codes 97153 and 97155 due to improper limit restrictions. Claims are now processing correctly as of October 28, 2022, and providers should review and rebill any previously denied claims for these codes.
Action Required
Immediately: Billing team must review all claim denials for CPT codes 97153 and 97155 that were denied due to limit restrictions since before October 28, 2022. Rebill these claims for reimbursement. Contact MHD.Education@dss.mo.gov with any billing questions related to these codes.