ABA Therapy Billing Services in Utah

Utah's aba therapy practices face unique billing challenges shaped by SelectHealth (Intermountain)'s commercial rules, Utah Medicaid requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both UT payer rules and aba therapy coding complexity.

AAPC Certified
UT Payer Expert
ABA Therapy Specialists
2.49% Rate
8,000+UT Physicians
2.49%Starting Rate
3Medicaid MCOs
98%+Clean Claim Rate

Why Utah ABA Therapy Practices Need Specialized Billing

Utah's healthcare market includes 8,000+ physicians, and aba therapy practices here face a payer market dominated by SelectHealth (Intermountain) on the commercial side and Utah Medicaid on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect aba therapy procedure coverage and medical necessity requirements. Generic billing teams without UT 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 Utah's specific payer rules, authorization requirements, and 3 Utah Medicaid 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 Salt Lake City to St. George and across Utah.

Top CPT Codes for ABA Therapy in Utah

Our UT coders handle these aba therapy codes daily, applying Noridian Medicare rules and SelectHealth (Intermountain) commercial policies to each claim.

Code
Description
97151
Assessment
97153
Adaptive
97155
Protocol
97156
Family

Utah Payer Challenges for ABA Therapy

Every UT payer has specific rules for aba therapy claims. Here's how we navigate them.

SelectHealth (Intermountain) ABA Therapy Claims

SelectHealth (Intermountain) processes the largest share of Utah commercial aba therapy claims. We know their UT 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.

Utah Medicaid ABA Therapy Billing

Utah Medicaid routes aba therapy patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own aba therapy authorization and billing rules that we manage.

Medicare (Noridian) ABA Therapy Coverage

Noridian processes Medicare aba therapy claims in Utah with its own Local Coverage Determinations. We navigate Noridian's policies around authorization limits to prevent medical necessity denials.

Denial Prevention for Utah ABA Therapy

Common aba therapy denials in Utah 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 UT payer-specific documentation when denials occur.

Get Expert ABA Therapy Billing in Utah

Free billing assessment for your UT aba therapy practice. See where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
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What We Handle for Utah ABA Therapy Practices

97151-97158 coding
Authorization tracking
Modifier compliance
Session documentation review
BCBA and RBT billing
Payer coverage policy tracking

Utah ABA Therapy Billing Cost Comparison

Hiring an in-house biller with aba therapy expertise in Utah costs $36K-$50K 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 UT payer specialists for a fraction of that cost.

$36K-$50K

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

Frequently Asked Questions

All major UT payers: SelectHealth (Intermountain), Regence, UHC, Molina, Utah Medicaid (including Healthy U, Molina, SelectHealth Community Care), and Medicare through Noridian. If a payer accepts aba therapy patients in Utah, we submit and follow-up on claims with them.
The most frequent aba therapy denials we see from UT payers include 15-minute increments must match documented time exactly, hours per week authorized, different levels of supervision require different modifiers. Our team catches these before submission by applying both aba therapy coding expertise and UT payer-specific rules to every claim.
Utah Medicaid routes aba therapy patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own aba therapy authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your aba therapy practice gets paid correctly.
Most UT aba therapy practices are fully transitioned within two to three weeks. We connect to your EHR, learn your aba therapy workflows, and start submitting claims to SelectHealth (Intermountain), Utah Medicaid, Medicare, and all your UT payers with no downtime.

Fix Your Utah ABA Therapy Billing

Call 888-701-6090 for a free billing assessment specific to your UT aba therapy practice. We'll show you where revenue is leaking and how to fix it.