Autism Spectrum Disorder (ASD)

Billing for Autism Spectrum Disorder (ASD) treatment and intervention services can seem daunting from the outset. We understand that. ASD is a developmental disorder that impairs the ability to interact and communicate, and often requires a multidisciplinary intervention approach involving a variety of professionals. Treatment for ASDs is defined to include habilitative or rehabilitative care, but not limited to, Applied Behavioral Analysis (ABA) therapy, pharmacy care, psychiatric care, psychological care, and therapeutic care (including outpatient physical, occupational, and speech therapies). Because every individual with ASD has unique symptoms, treatment plans are tailored towards their needs. The provider who develops the treatment plan will need to specify what services they believe are medically necessary to help avoid claim denials in the future. It is therefore important for ASD related service providers to be familiar with the various code sets and coverage policies for autism billing and reimbursement. However, the changing diagnosis and classification criteria of autism is making ASD coding and billing more difficult, and in turn increasing reimbursement challenges.

3Gen Consulting takes a methodical approach to managing the revenue cycle of ASD related service providers, wherein we implement changes customized to an organization’s goals, which will result in relatively rapid improvements. We use the appropriate codes and submit clean claims for ASD related services and take steps towards optimizing the overall autism coding and autism billing services process, which will be beneficial for an organization in the long-run.

Our ASD Revenue Cycle Management Solutions

Even though most states require insurers to provide coverage for ASD related treatment, policies vary and so do autism coding and billing guidelines. Our experts in each area of the revenue cycle, including eligibility verification and prior authorization, autism coding, autism billing and accounts receivable and denial management, will alleviate your revenue cycle burden.

Eligibility Verification & Prior Authorization

Patient Demographics

& Coding Audits

Charge Entry &
Claims Submission


Accounts Receivable


Clinical Documentation Improvement

Applied Behavioral Analysis (ABA) Therapy Billing Services

Our services include coding suggestions along with an in-depth review of OASIS. Our team is able to review your organization’s documents and provide relevant suggestions for effective ICD coding. We also review OASIS M-items to ensure they accurately reflect patients’ conditions and support the available codes at the time.

There are many types of treatments available for ASD, such as behavioral, developmental, educational, pharmacological and psychological, among others. Applied Behavior Analysis (ABA) is the most evidence-based treatment for individuals with ASD. It is a type of therapeutic intervention that can enhance social, communication, and learning skills through reinforcement techniques. ABA services are provided by licensed board-certified behavior analysts (BCBAs), board-certified assistant behavior analysts (BCaBAs), qualified behavioral health professionals (QBHPs), and behavior technicians (BTs).

It’s safe to say that ABA billing is complex and requires expertise to reduce the ABA therapy billing and insurance services burden. 3Gen Consulting is one of the leading ABA billing companies, with deep-domain expertise in ABA therapy billing services to relieve practitioners from the administrative burdens, while increasing reimbursement. Our ABA medical billing services are designed to assist providers to grow their practice and offer them more time to provide the best care to their patients.

Autism ABA Therapy

The 3Gen Advantage

ASD coding and billing, primarily ABA billing, is challenging and requires qualified and experienced resources to guide you on best practices to maximize reimbursement. We focus on providing cost-effective and high-quality autism coding and billing services, while you can focus on providing more time on patient care. Our goal is to partner in your growth, which is why our scalable ASD billing solutions are designed to get you paid faster and more efficiently. Still not convinced? Here are some additional reasons to highlight the 3Gen autism billing service difference.

Effectively navigating through the nuances of the healthcare regulatory environment, including payer policies, authorization requirements, autism coding guidelines and billing rules, is challenging. If providers submit claims without remaining updated on these changing regulations, they can face severe non-compliance penalties. 3Gen’s team is regularly trained on industry updates and constantly adapts processes to industry changes to ensure our clients remain in compliance.

It’s no secret that autism coding and billing is a burdensome task for providers. Managing claims, following up on receivables, staying updated on regulations is time consuming. We leverage our people and processes to devise strategies and guide you on best practices to streamline operations, improve productivity and in turn increase efficiency. In our commitment to provide the best autism billing services, we have audits built into our process to consistently maintain high accuracy levels.

Providers are struggling with reimbursement challenges, primarily because it’s hard to find enough qualified resources to manage claims appropriately. 3Gen’s experienced and scalable team is well-versed in the intricacies of autism medical billing services. Our AAPC certified coders are proficient in assigning appropriate ICD, CPT, HCPCS codes and modifiers, while our billers are experienced in processing claims with commercial and federal payers.

Managing autism coding and billing in-house can be expensive. Cost savings is one of the primary motivators that drive providers towards outsourcing. With 3Gen’s autism billing services, not only do you save costs associated with the process, such as salaries and benefits for staff, technology, hardware and training costs, you also strengthen cash flow through timely clean claims submission and improved reimbursement. Your profitability will significantly improve when you partner with us.

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