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Behavioral Health Forms Get a Facelift

Posted December 28, 2018

Starting, Jan. 1, 2019, you may notice some changes to Blue Cross and Blue Shield of Illinois (BCBSIL) behavioral health request forms. The changes may help make it easier for you to navigate the forms. The forms also include the new Current Procedural Terminology (CPT®) codes for Applied Behavioral Analysis (ABA). 

Also, several of the new forms can be submitted using iExchange®. For example, in-network providers can submit an initial Intensive Outpatient Program (IOP) or Electroconvulsive Therapy (ECT) request for up to 12 sessions using iExchange. The instructions at the top of each form indicate the preferred method for submission. 

Please use the appropriate CPT codes for 2019 as communicated by the American Psychological Association and the American Medical Association. 

The changes to the forms are summarized below. 

A new ABA Clinical Service Request Form has replaced the following forms:

  • ABA Initial Treatment Request
  • ABA Managed Care/Concurrent Review
  • ABA Treatment Request Member Schedule forms

A new ABA Initial Assessment Request Form has been added.

Updates have been made to the following existing forms:

Refer to the Forms page for the most recent versions of these and other forms.

The information in this article is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are to their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.

iExchange is a trademark of Medecision, Inc. (Medecision), a separate company that provides collaborative health care management solutions for payers and providers. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Medecision. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.

CPT copyright 2018 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.