Skip to main content

Applied behavior analysis (ABA) provider FAQs


Does ABA require precertification?

Yes, ABA is on the Aetna® precertification list for behavioral health services.


Who can I contact with benefits and claims questions?

You can see these contact details or just call the number on the member’s ID card.


How do I get services precertified?

You can call the number on the member’s ID card and speak to a customer service representative. Here’s more information on precertification. You may also use the ABA Treatment Request form (PDF), when applicable.


Where can I find the Aetna medical necessity guidelines for ABA?

See the Applied behavior analysis medical necessity guide (PDF).


Where can I find the Aetna clinical policy bulletin on autism spectrum disorders?

See Autism Spectrum Disorders and Applied Behavior Analysis.


What procedure codes does Aetna use for ABA?

Aetna continues to use the American Medical Association (AMA) CPT® (Current Procedural Terminology®) codes for adaptive behavior treatment. The AMA replaced or revised the following codes effective January 1, 2019:

Eight new Category I codes for adaptive behavior assessments (97151 and 97152) and adaptive behavior treatments (97153–97158) were added.

Fourteen associated Category III codes (0359T, 0360T, 0361T, 0363T–0372T and 0374T) have been deleted.

Two Category III codes (0362T and 0373T) were revised and maintained.


How do I join the Aetna network?

See joining the Aetna network.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

Also of interest: