ABA Therapy Billing Services in New York
New York's aba therapy practices face unique billing challenges shaped by Empire BlueCross BlueShield's commercial rules, NY Medicaid Managed Care requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both NY payer rules and aba therapy coding complexity.
Why New York ABA Therapy Practices Need Specialized Billing
New York's healthcare market includes 90,000+ physicians, and aba therapy practices here face a payer market dominated by Empire BlueCross BlueShield on the commercial side and NY Medicaid Managed Care on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect aba therapy procedure coverage and medical necessity requirements. Generic billing teams without NY specific knowledge leave revenue on the table.
ABA Therapy billing itself is complex. ABA uses specific CPT codes with 15-minute time increments, supervision requirements, and documentation thresholds. Authorization tracking is critical. When you combine this coding complexity with New York's specific payer rules, authorization requirements, and 6 NY Medicaid Managed Care managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving aba therapy practices from New York City to Albany and across New York.
Top CPT Codes for ABA Therapy in New York
Our NY coders handle these aba therapy codes daily, applying Novitas Solutions Medicare rules and Empire BlueCross BlueShield commercial policies to each claim.
New York Payer Challenges for ABA Therapy
Every NY payer has specific rules for aba therapy claims. Here's how we navigate them.
Empire BlueCross BlueShield ABA Therapy Claims
Empire BlueCross BlueShield processes the largest share of New York commercial aba therapy claims. We know their NY specific fee schedules, prior authorization requirements for aba therapy procedures, and their appeal timelines when claims are denied. 15-minute increments must match documented time exactly.
NY Medicaid Managed Care ABA Therapy Billing
NY Medicaid Managed Care routes aba therapy patients through 6 managed care plans: Fidelis Care, Healthfirst, MetroPlus, and 3 more. Each MCO has its own aba therapy authorization and billing rules that we manage.
Medicare (Novitas Solutions) ABA Therapy Coverage
Novitas Solutions processes Medicare aba therapy claims in New York with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around authorization limits to prevent medical necessity denials.
Denial Prevention for New York ABA Therapy
Common aba therapy denials in New York include 15-minute increments must match documented time exactly and hours per week authorized. Our team catches these issues before submission and appeals aggressively with NY payer-specific documentation when denials occur.
Get Expert ABA Therapy Billing in New York
Free billing assessment for your NY aba therapy practice. See where revenue is leaking.
What We Handle for New York ABA Therapy Practices
New York ABA Therapy Billing Cost Comparison
Hiring an in-house biller with aba therapy expertise in New York costs $45K-$62K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified aba therapy coders and NY payer specialists for a fraction of that cost.
$45K-$62K
In-House Biller Salary
+ benefits, software, space
2.49%
Go Medical Billing Rate
Full team, all services included
60-80%
Typical Cost Reduction
With better results
Related Pages
Explore our New York and aba therapy billing resources.
Frequently Asked Questions
Fix Your New York ABA Therapy Billing
Call 888-701-6090 for a free billing assessment specific to your NY aba therapy practice. We'll show you where revenue is leaking and how to fix it.