Maryland ABA Therapy Billing Services

When it comes to Maryland ABA Therapy Billing Services, accuracy isn’t optional—it’s everything. ABA Therapy Providers face one of the most complex billing landscapes in healthcare, balancing behavior plans, data collection, supervision, modifiers, and strict documentation requirements. Whether you run a home-based ABA program, a large clinic, or a hybrid model, your ability to get paid hinges on how well your billing process works.

In this blog, we’ll cover the essentials of Maryland ABA therapy billing, why it’s more than just CPT codes, and how Taylor Prime Solutions helps you get paid on time—every time.

📞 Call 844-TAYLOR-9 or 📩 Schedule a Free Consultation to discover how we can support your ABA practice.

ABA Therapy Billing Is Complex

ABA therapy billing requires more than standard insurance submission. Insurance companies often require:

Specific CPT/HCPCS codes based on session type
Modifier usage (e.g., HM, HO, GO, 95 for telehealth)
Daily documentation tied to treatment goals
Pre-authorizations and re-authorizations
Parent training logs and supervisory requirements

Unlike general medical billing, Maryland ABA billing involves multiple session types and billing scenarios, such as:

Direct therapy
Supervision
Assessment & reassessment
Parent and caregiver training
Group vs. individual sessions
Telehealth services

One mistake in documentation or code selection could lead to claim denials, audits, or lost revenue.

Common ABA Therapy Billing Codes

Here are some of the most commonly used CPT codes in ABA therapy billing:

CPT Code Description

97151 Initial behavior identification assessment by QHP

97153 Direct treatment by technician, face-to-face

97155 Treatment with protocol modification by QHP

97156 Family adaptive behavior treatment guidance

0362T Group adaptive behavior treatment with protocol modification

Each code is tied to a specific service model and must be used correctly to ensure payment. Additionally, different payers (especially Medicaid vs. Commercial insurance) may interpret code guidelines differently, making it vital to have an experienced billing partner.

The Role of Pre-Authorization and Reauthorization

One of the most time-consuming parts of ABA therapy billing is authorization management. Most insurance companies require:

A pre-authorization before treatment begins
Re-authorization every 3 to 6 months
Clinical documentation to justify continued services

Missing an auth deadline can result in unpaid sessions—even if the treatment was necessary. At Taylor Prime Solutions, we track all your auths and deadlines so you never miss a window or lose revenue due to administrative errors.

Telehealth and ABA Therapy Billing

Post-COVID, telehealth has become a crucial part of ABA services, but billing for it adds complexity. You must:

Use the correct CPT codes with the 95 modifier
Ensure sessions meet the payer’s criteria for remote services
Keep supporting documentation like session logs and notes

Whether you’re billing 97153 via telehealth or offering parent training remotely (97156), our team ensures everything is documented and billed in full compliance.

How Taylor Prime Solutions Supports Maryland ABA Therapy Providers

At Taylor Prime Solutions, we specialize in ABA therapy billing. This isn’t a small part of what we do—it’s what we do best. Here’s how we support ABA providers across the country:

✅ Submit Clean Claims Every Time

We handle full-cycle billing with CPT codes 97151, 97153, 97155, 97156, 0362T, and more. Each claim is scrubbed and submitted with the right modifiers, documentation, and payer requirements.

✅ Insurance Authorization Support

From initial auth to every re-auth, we help you gather and submit the documentation needed to keep services going without interruptions.

✅ Supervision & Group Session Billing

We’re familiar with group billing limitations and supervision rules, so you don’t get flagged for improper usage.

✅ Telehealth Compliance

We ensure your telehealth services are billed correctly with the 95 modifier and payer-specific rules.

✅ Seamless EMR Integration

We work with the EMRs ABA providers already use:

CentralReach
Rethink
DataFinch / Catalyst
Accupoint
TheraWe

When it comes to billing to Commercial payers, Medicare, or Medicaid, your claims accepted and paid fast.

Maryland ABA Therapy Billing Services for Every Practice Model

We support ABA therapy providers across all settings:

🏠 Home-Based Practices
🏢 Clinic-Based Programs
🌐 Hybrid Telehealth Models

The goal is to let you focus on the care, while we handle the revenue.

📌 “You do the therapy. We handle the billing.” That’s the Taylor Prime promise.

The Risks of DIY Maryland ABA Therapy Billing

Some providers try to manage their own billing—or hand it off to an admin without training. Unfortunately, this often leads to:

Delays in payment
Incomplete documentation
High denial rates
Hours wasted fixing preventable mistakes

Your time is better spent working with your clients—not chasing insurance companies. That’s why outsourcing ABA therapy billing to specialists like Taylor Prime Solutions pays off quickly.

What to Look for in a Maryland ABA Therapy Billing Services Partner

When you consider outsourcing your billing, look for:

✅ Deep knowledge of ABA services and CPT coding
✅ Experience with major ABA EMRs
✅ Medicaid and commercial insurance expertise
✅ Transparent pricing and reporting
✅ Strong communication and support

Taylor Prime Solutions checks every box.

ABA Therapy Billing Shouldn’t Be a Burden

As an ABA provider, your passion is helping clients thrive— it should not be navigating insurance codes and authorization policies. With Taylor Prime Solutions, you gain a team that understands the real challenges of Maryland ABA therapy billing—and knows how to solve them.