For families to access Developmental Approaches including DIRFloortime and other Developmental Relationship-Based Interventions (DRBI), new insurance billing codes are needed.
Write a letter of support for new billing codes for evidence-based Developmental Approaches - sample letter below....
| Sample Letter New Billing Codes for DRBIs.docx |
Fact Sheet re: Urgent Need for Dedicated Billing Codes for Developmental Relationship-Based Interventions (DRBI)
The Problem: Families seeking evidence-based autism care face inconsistent insurance coverage when pursuing Developmental Relationship-Based Interventions (DRBI).While Applied Behavior Analysis (ABA) has long had dedicated national billing codes aligned with its service model, no comparable codes exist for DRBI—despite:
Why It Matters: The absence of dedicated DRBI billing codes results in:
Policy Context: California’s 2026 requirement that insurers cover evidence-based autism treatments beyond ABA highlights this gap. However, this is a national issue requiring national alignment.
The Solution: Establish dedicated national billing procedure codes for DRBI.
This would:
Request:
We respectfully request your letter of support to CMS HCPCS Code Team [email protected] for the national DRBI billing code applications (see Sample Letter)
Clear, consistent billing codes are essential to ensuring equitable access to modern autism care.
The Problem: Families seeking evidence-based autism care face inconsistent insurance coverage when pursuing Developmental Relationship-Based Interventions (DRBI).While Applied Behavior Analysis (ABA) has long had dedicated national billing codes aligned with its service model, no comparable codes exist for DRBI—despite:
- A growing evidence base
- Widespread clinical implementation
- Increasing family demand
Why It Matters: The absence of dedicated DRBI billing codes results in:
- Uneven access to evidence-based care
- Administrative burdens and payment delays
- Distorted cost and outcome data
- Reduced family choice among validated treatment options
Policy Context: California’s 2026 requirement that insurers cover evidence-based autism treatments beyond ABA highlights this gap. However, this is a national issue requiring national alignment.
The Solution: Establish dedicated national billing procedure codes for DRBI.
This would:
- Align reimbursement with current clinical science
- Promote consistent insurance coverage
- Improve data integrity for research and cost analysis
- Protect family choice in evidence-based autism treatment
Request:
We respectfully request your letter of support to CMS HCPCS Code Team [email protected] for the national DRBI billing code applications (see Sample Letter)
Clear, consistent billing codes are essential to ensuring equitable access to modern autism care.
