Summary & Overview
CPT 0374T: Exposure Adaptive Behavior Treatment, Additional Technician Time
CPT code 0374T represents exposure adaptive behavior treatment with protocol modification, specifically for cases involving severe maladaptive behaviors that require two or more technicians. This code is billed for each additional 30 minutes of face-to-face technician time, supplementing the primary procedure. The service is categorized under behavioral health and adaptive behavior treatment, and is most commonly performed in inpatient hospital settings.
Nationally, this code is significant for providers and facilities managing complex behavioral health cases, particularly those involving patients with conditions such as autistic disorder or childhood disintegrative disorder. The code is recognized by major payers, including Blue Cross Blue Shield, and is relevant for tracking policy updates, reimbursement benchmarks, and clinical utilization trends in behavioral health.
Readers will gain insight into the clinical context of CPT 0374T, its role in adaptive behavior treatment protocols, and the payer landscape for this service. The publication also highlights associated modifiers, taxonomies, and related codes, providing a comprehensive overview for stakeholders in behavioral health billing and policy.
CPT Code Overview
CPT 0374T is designated for exposure adaptive behavior treatment with protocol modification that requires the involvement of two or more technicians to address severe maladaptive behaviors. This code is used for each additional 30 minutes of technicians’ face-to-face time with the patient, and is listed separately in addition to the primary procedure. The service type falls under behavioral health and is classified as adaptive behavior treatment (Category III). The typical site of service for this procedure is the inpatient hospital setting, specifically at Place of Service 21.
Clinical & Coding Specifications
Clinical Context
A patient with severe maladaptive behaviors associated with an autism spectrum disorder, such as aggressive outbursts or self-injury, is admitted to an inpatient hospital setting. The clinical team determines that exposure adaptive behavior treatment is necessary, requiring protocol modification and the involvement of two or more technicians. The primary procedure involves the first 60 minutes of face-to-face technician time. If additional time is required, the service is extended in 30-minute increments, documented using CPT code 0374T. The workflow includes ongoing assessment, protocol adjustments, and direct patient interaction to address severe behavioral challenges.
Coding Specifications
-
Modifiers:
Modifier Code Description 26Professional Component TCTechnical Component 59