For guidelines for 2019 CPT codes and reporting of the Practical Functional Assessment (PFA) and Skill-Based Treatment (SBT) process for Michigan providers, click here. This resource was created by Brie Elsasser and Morgan VanDenBerg of Autism Centers for Michigan and the Michigan Department of Health and Human Services.
This resource is intended to be a quick reference guide for Medicaid providers in Michigan to have some suggestions on which of the already allowable service codes they should consider using for different parts of the PFA and SBT process. The codes in the column on the left are the CPT codes they’d use to report the service in order to get reimbursed. The guidance on page 2 is for anyone using the process for individuals who have approval under the State Plan (doesn’t require an ASD diagnosis) rather than those receiving services under the EPSDT authority (requires an ASD diagnosis).