Prior Authorization Coding Guidance

All direct treatment hours (represented by CPT codes 0364T, 0365T, 0368T, and 0369T) for behavioral treatment must be requested as a single lump sum using CPT code 0365T (Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient; each additional 30 minutes of technician time [List separately in addition to code for primary procedure]). Family adaptive behavior treatment guidance hours must be requested separately using CPT code 0370T (Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional [without the patient present]).