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Tricare ABA Billing for RBTs

C

Cwebb85

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Austin, TX
We are receiving conflicting information and Tricare's manual is worded in a confusing manner. If we have an RBT (Registered Behavior Technician) that is Tricare certified, do we bill for their services (97153) under their NPI? Or under the supervising BCBA?
 
Under the NPI/name of the certified RBT (who performed ABA services 1:1 with beneficiary - 97153) - Box 24J is to indicate the rendering provider.

Refer to TRICARE Operations Manual - TRICARE ABA Manual can be located at https://manuals.health.mil/pages/v3...l=TO15&Change=79&Type=AsOf&Filename=C18S4.PDF

There are 3 levels of ABA reimbursement depending on provider type - (less any network discounts of provider/CSP - who receives the reimbursement)
CPT 97153. Adaptive Behavior Treatment by Protocol. CPT 97153 is a timed codes reimbursed at $31.25 per 15-minute increments ($125.00/ hour) for authorized ABA supervisors, $18.75 per 15-minute increment ($75.00/hour) for assistant behavior analysts, and $12.50 per 15-minute increment ($50.00/hour) for BTs.
 
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