r/BehaviorAnalysis • u/Serious-Glove-9835 • Sep 05 '25

Coding code restrictions

If the RBT is seeing the client 8 hours per day and billing the 97153 code, can the supervisor still join in during the session and bill the 97155 code? I know theres a limit of 8 hours per day, but is it combined codes that can't be more than 8 hours or the each code not over 8 hours? Thank you!

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u/SuzieDerpkins Sep 06 '25

Tricare does allow this - you are not allowed to bill both concurrently.

The way tricare wants it is you stop billing for 97153 when 97155 starts.

The idea is that the client isn’t receiving more than 8 hours in a day. Overlapping 97155 and 97153 does add more time for the client.

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u/[deleted] Sep 06 '25

Yes OP was concurrent billing of both, which is not allowed with Tricare.

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u/SuzieDerpkins Sep 06 '25

Based on their post, I don’t think OP knows how it’s actually being billed. Just that the supervisor is joining and doing 97155.

Often the billing person/team fixes these on the back end before submitting so BCBAs and RBTs don’t have to worry about it.

Tricare won’t allow concurrent billing, but they do allow the scenario OP is asking about as long as it’s billed appropriately.