HCPCS vs CPT Codes in ABA Therapy 2025 Update

One of the most important aspects of running an ABA therapy practice is billing. When your coding is good, you avoid denials, claims get processed quickly, and payments arrive on time. But even small coding errors can cause headaches for your billing team and slow down your cash flow.

The main ABA therapy code changes for 2025 are described in this article. Updates to both CPT and HCPCS codes will be discussed, along with what it means for billing and how to keep your ABA practice successful.

Before we get into the changes, let’s take a minute to review the difference between CPT and HCPCS codes and why you need both codes in your billing toolbox.

Understanding CPT and HCPCS Codes for ABA Therapy

CPT codes

The American Medical Association updates the Current Procedural Terminology, or CPT, codes. These codes describe the services medical professionals offer. The CPT codes for ABA therapy cover core services such as parent education, supervision, direct therapy sessions, and assessments. Insurers can use these codes to describe what you do and how to bill for it.

HCPCS code

HCPCS codes are different from CPT codes but similar.CPT codes do not cover goods, equipment, or services that are covered by HCPCS Level II codes.  These are especially important when billing government payers like Medicare and Medicaid. HCPCS also includes items associated with ABA therapy and some behavioral health services.

CPT and HCPCS work together to give a complete picture of your practice. Using both correctly is key to efficient billing and timely reimbursement.

Now that we have that foundation, let’s look at the 2025 updates to CPT codes.

2025 CPT Codes for ABA Therapy

The AMA updates CPT codes every year to make them clearer and more current. Some ABA CPT codes for 2025 have changed.

CPT Code 97151, behavior identification assessments, now has guidelines on what to do and document. This reduces billing confusion and errors.CPT Code 97155, adaptive behavior treatment by protocol, has new guidance on how to track and bill time. This makes it easier to bill for the therapy time you deliver.

CPT Code 97156, family adaptive behavior treatment guidance, now requires more detail. Your notes need to match what you bill.

Modifiers and billing rules for supervision and split sessions have been clarified. These changes will reduce common mistakes like billing too many units or misusing modifiers

ABA Billing teams that get this right will see fewer denials and faster payments.

Now let’s look at the 2025 HCPCS codes.

2025 HCPCS Codes for ABA Therapy

While CPT codes cover most ABA services, HCPCS codes still matter when billing government programs like Medicare and Medicaid. New or updated HCPCS codes for behavioral health services may be released in 2025. These changes are to improve billing accuracy and reflect current treatment approaches. You may need to use these new HCPCS codes for assessments, behavioral supports, or equipment if you bill Medicaid or Medicare.

Secondary billing for services other than direct therapy, like family counseling or psychological testing, may also be affected by some changes. Your claims will process faster and easier if you use the correct HCPCS codes and document thoroughly. After we discuss changes to both CPT and HCPCS codes, let’s talk about when to use each set of codes in ABA billing.

CPT vs HCPCS: What’s the Difference for ABA Providers

The main difference is that CPT codes are used on commercial insurance claims. They cover your team’s ABA therapy sessions, assessments, and parent or caregiver training.

HCPCS codes are utilized when billing Medicare, Medicaid, and other government programs. They cover any additional services or materials not covered by CPT code billing.

The rules are different. Commercial payers expect CPT codes, but government programs require HCPCS codes for certain claims.

 Using the wrong codes or not following the new 2025 documentation guidelines will result in claim denials and delayed payments. 

That means more time chasing unpaid claims. Common mistakes are charging CPT codes to Medicaid instead of HCPCS and misapplying time units and modifiers under the new rules. Knowing when and how to use CPT instead of HCPCS saves revenue and time wasted chasing claims.

Now, here are some practical tips to help your billing team navigate these changes.

Practical Tips for ABA Providers and Billing Teams

Every year, coding changes happen, so staying current is key. In 2025, follow these tips to stay billing effective:

Check official sources frequently, CMS for HCPCS and Medicare/Medicaid updates, and the American Medical Association for CPT changes.

Teach your billing staff the new codes and rules using examples from your practice.

Update your ABA billing software regularly. Although most systems update automatically, check manually

Pay attention to detailed documentation. All the codes you bill should be supported by your notes. If it gets too complicated or you’re unsure about the changes, consider an ABA-focused revenue cycle management company.

Do regular audits to catch errors before payers do. Early error correction gets paid faster.

Follow these guidelines to avoid denials and streamline your billing process.

FAQ

1. How many new codes get added in CPt 2025?

CPT 2025 brings 270 brand‑new codes, alongside 38 revisions and 112 deletions. Total updates hit 420—reflecting the fast pace of medical innovation and procedural change.

2. What is the difference between CPT and HCPCS codes?

CPT codes (five‑digit numbers) are created by the AMA for physician services. HCPCS includes CPT (Level I) plus Level II alphanumeric codes for supplies, equipment, and Medicare‑specific services.

3. Are HCPCS codes updated every year?

Yes. HCPCS Level II updates hit every January 1, with additional quarterly updates (April, July, October) as needed to keep pace with new supplies, equipment, and services.

Conclusion

Keeping up with the 2025 CPT and HCPCS code changes might seem like just another thing on your to-do list. But here’s what this means for your practice: faster payments, fewer denials, and a smoother billing process overall.

Clear documentation, up-to-date software, and well-trained employees are the foundation of successful billing. When you get these right, you free yourself and your team to focus on what matters most—your clients.

When changes come your way, you don’t have to face them alone. At Cube Therapy Billing, we know ABA therapy billing inside and out. Our team consistently achieves a 98.8% payment success rate by working to secure the highest possible reimbursements while keeping denials to a minimum. You focus on your clients—we’ll take care of the billing details that keep your practice running smoothly.