For Providers: ABA Billing Requirements

Date: 09/08/26

ATTENTION ABA PROVIDERS

REASSESSMENTS REQUIRE MODIFIER TS IN POSITION 1

Effective September 16, 2026: 
All ABA reassessment
PROVIDER EDUCATION REMINDERservices billed under CPT 97151 must include modifier TS in Position 1 on the claim.

Failure to bill modifier TS in Position 1 may impact

Billing Requirements for ABA Reassessments (CPT 97151)identification and processing of ABA reassessment services.

Oklahoma Complete Health is providing this reminder regarding billing requirements for Applied Behavior Analysis (ABA) assessments and reassessments billed under CPT 97151.

Billing Guidance

• Providers should continue submitting prior authorization requests as they do today,
• The first billed CPT 97151 should be submitted as the initial assessment.
• ABA reassessments must be billed using modifier TS in Position 1.
• All reassessments should be:
  • Clinically supported
  • Based on medical necessity
  • Timed according to clinical need (generally aligned with a ~6-month interval)

Important Reminder
To ensure proper identification and processing of reassessment services:

Modifier TS must be billed in Position 1 on CPT 97151 reassessment claims.
Claims submitted for reassessments without modifier TS in Position 1 may be subject to review and may not process as intended.

Effective Date
Implementation Date: September 16, 2026

Questions
For questions regarding this reminder, please contact your Provider Engagement Account Manager or Provider Services at 1-833-752-1664. Thank you for your continued partnership in serving our members.