HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 19, 2025
Corrected ABA claim denials for codes 97152, 97153, and 97154
The Medicaid Operations team has identified an issue causing applied behavior analysis (ABA) claims submitted under codes 97152, 97153, and 97154 without a modifier to be incorrectly denied with code PS0 - Not a covered service and CARC code 204.
We have updated our claims processing system to align with state guidance for these codes. The Claims Escalation team is conducting a thorough review and will reprocess all affected claims. The reprocessing was completed on or before January 10, 2025. We apologize for any inconvenience and appreciate the care you provide to our members.
Contact and support
If you have any questions about this communication, call Anthem HealthKeepers Plus Provider Services at 800-901-0020.
HealthKeepers, Inc. is an independent licensee of the Blue Cross Blue Shield Association. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Medicaid benefits to enrollees. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
VABCBS-CD-072811-24
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