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      Nikula
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      Place of service code: 99. Details: For authorizations approved on or after Aug. 1, 2021, HNFS will make specific coverage determinations for ABA services in community settings (to include provider types, units, etc.) during the treatment plan clinical necessity review process. Specific exclusions apply to sporting events, camps and medical
      A. Per the TRICARE Operations Manual, Chapter 11, Section 4, every session of ABA services must be identified as its own unique line on claims submitted. To ensure your claims don’t reject when billing for multiple services rendered on the same day by the same rendering provider, you must separate out sessions, even if the CPT code is the same.
      The comprehensive changes to TRICARE’s ACD towards a truly comprehensive program that integrates all potential services for the best possible outcomes tailored to the beneficiary. The ACD program changes will: Move the ACD to a beneficiary-centric model to help beneficiaries reach maximum potential
      By October 1, 2021, providers will be required to attend provider education training at least annually. Effective May 1, 2021, TRICARE will no longer be authorizing school-based services rendered by RBTs. Existing authorizations with approved school-based services will be allowed to continue for the duration of the authorization period.
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