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Serving ABA providers across florida

ABA Medical Billing Services for Florida Practices

Cube Therapy Billing manages the full billing cycle for Florida ABA practices, from Medicaid managed care claims and prior authorizations to denial management, payment posting, AR follow-up, and credentialing.
Your team stays focused on therapy while we keep claims moving, watch for payer issues, and follow each claim through payment.

30-minute call. No pressure. You'll leave with a clear read on your claims, even if we never work together.

What ABA providers get with Cube Therapy Billing

Verified performance across ABA practices we bill for.

Clean claim rate

98.9%

Average AR days

18 days

Denial rate

Under 3%

Net collection rate

98%

Payer coverage

Medicaid MCOs + Commercial

98.9% Clean Claim Rate

Claims are reviewed before submission for coding, authorization, provider, and payer requirements.

18 Average AR Days

We follow unpaid claims consistently so balances do not sit without action.

Under 3% Denial Rate

Our team checks authorization, coding, eligibility, and provider details before claims go out.

98% Net Collection Rate

We focus on the full billing cycle, not just claim submission.

Quick Answer: ABA medical billing in Florida depends on more than clean claims. Authorization, CPT codes, units, provider type, modifiers, and payer rules all need to match. Cube Therapy Billing manages those details and follows claims through payment, denial resolution, and AR follow-up.

Sound familiar?

Why Florida ABA Practices Come to Us

Florida ABA billing becomes difficult when managed care rules, authorizations, credentialing, and claims are handled separately. Small gaps can quickly turn into denied claims or aging AR.

Denials Keep Coming Back

A claim gets corrected, then the same denial appears again. We look at the root cause so the issue can be fixed before it affects more claims.

Authorizations Are Hard to Track

Approved CPT codes, units, service dates, and provider requirements all need to stay aligned. Missing one detail can put completed sessions at risk.

Managed Care Rules Vary

Florida Medicaid behavior analysis is tied closely to managed care, so plan-specific authorization and claim requirements need to be checked before billing.

AR Keeps Getting Older

Unpaid claims can build up when staff are balancing payer follow-up with daily practice operations. We keep older claims moving with consistent follow-up.

Provider and Modifier Rules Matter

Florida Medicaid uses provider-level billing rules and modifiers for several behavior analysis services. The claim needs to match the service and provider type.

Limited Visibility Into Claims

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Florida payer rules

Florida ABA Billing Rules Your Team Needs to Get Right

ABA medical billing in Florida is closely tied to Medicaid managed care, prior authorization, provider qualifications, CPT-specific limits, and payer requirements. A claim can be documented correctly and still be delayed or denied when the authorization, provider, modifier, or billed units do not match.

Florida Medicaid Behavior Analysis Coverage

Under Age 21

Prior Authorization Required

Medical Necessity Documentation Required

Florida Medicaid uses specific billing rules for behavior analysis services. The 2026 fee schedule includes codes such as 97151, 97153, 97155, 97156, 97154, 97158, 0362T, and 0373T.
Prior authorization and medical necessity apply to certain services. Practices should verify approval requirements before treatment and keep approved units and service dates aligned with billing.
Provider type matters. The fee schedule distinguishes between services performed by Lead Analysts, BCaBAs, and RBTs for several ABA codes.
Modifier rules matter too. Florida Medicaid uses modifiers such as HN, XP, GT, and group-size modifiers for specific services, so the claim needs to reflect the actual service delivered.
Service limits vary by code. For example, Florida Medicaid sets unit limits for certain assessments, reassessments, group services, and caregiver training services.

Sunshine Health

Simply Healthcare Plans

Humana Medical Plan

UnitedHealthcare Community Plan

Aetna Better Health of Florida

Florida Medicaid ABA CPT Rules

Physician Referral Required

Provider and Modifier Rules Apply

Prior Authorization

97151 is reimbursed in 15-minute units, with a maximum number of units allowed per behavior assessment.

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How Our Multi-Payer ABA Billing Services Handle Different Payers

Our multi-payer ABA billing services are built to reduce avoidable denials, prevent authorization-related billing errors, and keep claims moving across different insurance plans.

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At Cube Therapy Billing, we do not use one billing process for every payer. We adjust claim setup, authorization checks, modifiers, provider details, and follow-up based on the specific rules of each commercial payer, Medicaid program, and managed care plan.

New Jersey's autism mandate requires state-regulated plans to cover medically necessary ABA. It took effect in February 2010 and is one of the stronger mandates in the country.

The original under-21 age cap and the 30-visit limits on OT, PT, and speech came off through later amendments, so adults with autism can now access covered ABA under state-regulated plans.

We check payer-specific billing requirements before claims are sent, helping reduce avoidable rejections and denials. When a payer denies or delays a claim, our team reviews the reason, corrects the issue, and follows up based on that payer’s process.
We keep billing workflows updated as commercial plans, Medicaid programs, and managed care organizations change their requirements.

Payer policies change often. Cube therapy billing verifies the current version of each payer's policy, fee schedule, and authorization requirements at intake and monitors updates for every client. The summary above reflects publicly posted payer policy at the time of writing and is not a guarantee of coverage.

End-to-end RCM

What We Handle for Florida ABA Therapy Practices

One team owns your full billing cycle. Nothing falls between vendors, and nothing depends on one overworked in-house biller.

01

Eligibility and benefit verification

Every client verified before intake: plan type, ABA benefit, deductible status, and whether the state mandate applies. No surprises at claim time.

02

Prior authorization management

We track approved dates, CPT codes, units, renewal activity, and payer requirements so authorization information stays connected to billing.

03

Clean claim submission

97151 through 97158, 0362T, 0373T, correct modifiers, correct rendering NPI, per each payer's rules. That's how we hold a 98.9% clean claim rate.

04

Root-cause denial management

Denials get worked in 24 to 48 hours, and the cause gets fixed upstream so the same denial doesn't come back next month.

05

AR follow-up and payment posting

Aggressive follow-up on every unpaid claim, ERA posting, and underpayment catches against your contracted rates.

06

Credentialing and MCO enrollment

We support payer enrollment, CAQH maintenance, credentialing, revalidation, and related setup so provider participation stays aligned with billing.

How switching works

From first call to first clean claim batch

Switching billing partners feels risky. Our onboarding is built so your cash flow never skips a cycle.

01

Billing review call

We look at your current AR, denial patterns, and payer mix. You get honest findings on the call, whether or not you sign.

02

Setup inside your EHR

Role-based access in your existing system. CentralReach, AlohaABA, Rethink, and 20+ others. No data migration drama.

03

Authorization audit

Every active auth logged with units, end dates, and payer. Anything expiring soon gets escalated within 48 hours.

04

Claims go live

New claims submitted clean under each payer's current NJ rules while we work your aging AR in parallel.

05

Denials worked at the root

Each denial gets appealed fast and traced back to its cause. Denial rate trends down month over month.

06

Reporting you can actually read

Weekly visibility into claims, collections, AR aging, and auth status through SparkzABA. No mystery deposits.

Why choose Cube

Why Florida Practices Pick Cube Therapy Billing

Plenty of billing companies can submit a claim. Fewer understand how ABA billing changes when provider type, authorization, modifiers, and payer-specific rules all affect reimbursement.

ABA-specialized, not general medical billing

Our team lives in 97151 to 97158, concurrent billing rules, supervision modifiers, and authorization cycles. Your claims aren't learning material for a generalist biller.

Florida Medicaid Billing Awareness

We follow Florida Medicaid's current behavior analysis fee schedule and code-specific billing rules so claims can be reviewed before submission. Florida Health Care Agency

First in the industry

SparkzABA: AI powered RCM workflow management

Every Cube client runs on SparkzABA, our RCM workflow management software with AI powered workflows, the first of its kind in the ABA billing industry. It tracks every claim, authorization, credentialing file, and eligibility check in real time, flags risks before they become denials, and gives you a live window into your revenue instead of a month-old PDF report.

Proactive denial prevention

We catch problems before claims go out: missing auths, wrong modifiers, unit overages against Horizon's daily limits. That's how our denial rate stays under 3%.

Credentialing and billing under one roof

MCO enrollment delays are one of the biggest revenue gaps for growing Florida practices. We run credentialing and billing together so new payers turn on faster.

Transparent reporting, HIPAA-compliant operations

Signed BAAs, role-based access, 2FA, and reporting that shows real numbers. You always know your clean claim rate, AR days, and what we're chasing this week.

Why choose Cube

How Cube compares to a typical billing provider

Ask any billing company for their numbers before you sign. Here are ours, next to commonly cited industry benchmarks for outsourced medical billing.

Metric

Cube Therapy Billing

Typical billing provider*

What it means for your practice

Clean claim rate
Average AR days
Denial rate
Net collection rate
Authorization tracking
Reporting visibility
Specialty focus
98.9%
18 days
Under 3%
98%
Proactive, escalated 48 hrs before risk
Live, via SparkzABA
ABA and therapy billing only
Roughly 85–90%
Often 35–45 days
Commonly 8–12%
Around 90–94%
Reactive, after the denial
Monthly summary PDF
All specialties, generalist staff
Fewer rejections, less rework, faster first-pass payment.
Cash hits your account weeks sooner. Payroll stops being a monthly stress test.
Fewer denied sessions means more of the hours you deliver actually get paid.
On $1M in billed charges, that gap can mean $40,000 or more per year.
Sessions never outrun the auth. Expiring units get renewed early.
You see claim status today, not four weeks from now.
Your biller already knows MCO quirks and Horizon's daily limits.

*Typical provider figures are approximate industry benchmarks for outsourced medical billing and vary by company. Cube figures reflect current verified performance across our client base.

Clear your doubts

Why Florida practices pick Cube Therapy Billing

These are the questions ABA practice owners actually ask us on the first call.

  • ABA medical billing covers the full insurance billing process for applied behavior analysis services. That usually includes eligibility verification, prior authorization tracking, claim preparation, CPT and modifier review, claim submission, payment posting, denial management, AR follow-up, and credentialing support. The goal is to make sure the service delivered, the authorization, the documentation, and the claim all match before the payer processes it. Cube Therapy Billing already structures its ABA billing services around that full revenue cycle.

  • Cube Therapy Billing works with the core ABA CPT code set, including 97151 through 97158, along with 0362T and 0373T where applicable. Claims are reviewed for coding, modifiers, rendering provider details, place of service, authorization, and payer-specific requirements before submission.

  • Yes. Cube manages ABA prior authorizations by tracking approved units, authorization dates, payer requirements, and upcoming expirations to help prevent avoidable claim denials. We also coordinate authorization details for different care settings, including Virtual ABA Therapy in New Jersey, where coverage and approval requirements may vary by health plan.

  • Yes. Cube’s denial management process includes reviewing the denial reason, correcting claim issues, appealing when appropriate, following up with the payer, and identifying the root cause so the same denial is less likely to repeat. The site positions denial work as part of the full billing cycle rather than simple claim resubmission.

  • Yes. Cube works with Medicaid programs, Medicaid managed care plans, and commercial payers. On its current site, Cube specifically references payer experience that includes Medicaid MCOs and commercial insurers such as Aetna, Cigna, UnitedHealthcare, and BlueCross BlueShield. 

  • Yes. Aging AR cleanup is usually part of onboarding. We audit unpaid claims, rework what's recoverable within timely filing limits, and give you an honest write-off recommendation on what isn't. Many practices recover meaningful revenue from claims they'd assumed were dead.

  • In most cases, yes. Cube says it works with more than 25 EHR and practice-management systems, including platforms such as CentralReach, AlohaABA, Rethink, Lumary, and Theralytics. The goal is to work inside the practice’s existing setup rather than force a full system migration.

Find out where your ABA practice is leaking revenue

If your team is chasing denials, babysitting authorizations, or waiting 40+ days to get paid, a 30-minute billing review will show you exactly what's fixable. No pitch deck. Just your numbers and straight answers.

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