On July 1, Anthem stopped paying the going rate for Applied Behavioral Analysis, according to the news station. For many providers, this meant a cut in reimbursement from the state’s largest insurer, with some providers saying they are facing as much as a 35 percent cut.
However, Anthem spokesperson Tony Felts told WTHR it is unfair to characterize the reimbursement change as a 35 percent cut. Mr. Felts said, “We have adjusted our fee schedule for applied behavioral analysis in order to mitigate the effects of revisions to the industry standard code reporting guidelines for this type of service, because those revisions could have the effect of increasing the cost of care.”
Patient advocates and providers are calling on the Indiana Department of Insurance, state lawmakers and other officials to address the change.
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