Early Intensive Behavioral Intervention Services
Posted on September 30, 2021
Early Intensive Behavioral Intervention Services (EIBI) is a treatment based on the principles of applied behavior analysis (ABA). The treatment offers someone who is diagnosed with autism the opportunity for improved learning, skill development and behavior changes.
When a Health New England member requires this type of treatment, a prior authorization is required. However, the plan the member resides under determines where the authorization is obtained from and where services are rendered. There are also different billing guidelines depending on the member. With that said, below is information to help guide you:
For our BeHealthy Partnership members, the EIBI services are managed through our partnership with Massachusetts Behavioral Health Partnership (MBHP). The authorizations should be obtained through them. When billing for these services, the following codes should be used, which includes the TL modifier.
For our Commercial members, the authorization is obtained from Health New England. An authorization form is located here https://healthnewengland.org/forms. When billing for these services, the following codes should be used:
For any additional questions, please call your Provider Relations Representative at (800) 842-4464 extension 5000. You may also send an email to providerrelations@hne.com.
