Issued: January 29, 2024

NC Licensed Behavior Analysts are now able to use their NPI to bill as a licensed clinician for Research Based Behavioral Health Treatment (RB-BHT) 97151 or 97151GT once their NPI is loaded in NCTracks and the provider’s contract is updated.   

What is happening? 

NC Licensed Behavior Analysts can use their NPI to bill as a licensed clinician for Research Based Behavioral Health Treatment (RB-BHT) 97151 or 97151 GT once their NPI Is loaded in NCTracks and the provider’s contract is updated.  

Utilization Management authorizes RB-BHT using an “all code” for each base code, providers will need to bill the appropriate code/modifier combination.   

When does this take effect? 

It is in effect now. 

Which RB-BHT code should providers use? 

Code: 97151 

  • 97151 or 97151GT is clinician based and should be billed with the clinician’s NPI.
  • 97151NC or 97151GTNC should be billed with the facility NPI and is intended to be used by Occupational Therapists (OT) or Speech and Language Pathologists (SLP) only. 

Code: 97152 

  • 97152 or 97152GT is clinician based and should be billed with the clinician’s NPI.
  • 97152NC or 97152GTNC should be billed with the facility NPI and is intended to be used by the Occupational Therapists (OT), Speech and Language Pathologists (SLP), certified QP or paraprofessional.

Codes: 97153-97157 

  • 97153- 97157 are not clinician based and should be billed with the facility’s NPI.

What if a provider’s 97152 claim has denied? 

Partners is reprocessing all claims that have been submitted for 97152. Please submit replacement claims for any that have denied due to not using the appropriate modifier and NPI. 

Who do providers contact if they need assistance?