Effective January 1, 2019, changes to CPT codes regarding the Autism Care Demonstration (ACD) were implemented. Learn more
The ACD adopted the new Category I CPT codes that directly transferred from the Category III codes. Specifically, the ACD has adopted 97151, 97153, 97155 and 97156. Providers should use the approved new codes for all services provided on or after January 1, 2019.
Due to the changes in ACD CPT codes, DHA has authorized four additional hours (16 units) of 97155 per month per beneficiary to ensure adequate time is allowed with each beneficiary for protocol modification. You do not need to request any changes to your authorization. Please reevaluate your treatment plans for the next authorization period and request units appropriately.
There are several key changes:
Prior authorization is required for laboratory developed tests except for Cystic Fibrosis (CF) testing. Claims for genetic testing submitted without an approved authorization will be denied. Find out more
Orthopedic cold therapy devices are not covered under TRICARE policy. Learn more
Urgent care can be rendered by either a TRICARE network provider or TRICARE-authorized urgent care center. Learn more
Self-service for providers offers many features that will save you time,
ensure patient privacy and help manage your office more efficiently.
Access materials that support provider education.
You can find the handbook, charts, newsletters, presentations, forms and more.