CPT® Code 97155

Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes

Adaptive behavior treatment with protocol modification, as described by CPT® Code 97155, involves a structured approach to addressing behavioral deficits in patients. This treatment is delivered face-to-face by a physician or another qualified healthcare professional, ensuring direct interaction and personalized care. The primary goal of this procedure is to modify existing treatment protocols to better meet the needs of the patient, particularly when previous strategies have proven ineffective or when the patient has plateaued in their skill development. The modifications may include adjustments to treatment goals, targets, and the overall administration of the session, all aimed at enhancing the patient's ability to develop essential skills in various contexts, such as during mealtimes, playtime, and self-care activities. The qualified professional not only implements these changes but also guides and supervises technicians in the application of the new protocols, providing necessary feedback to ensure effective delivery of the treatment. This code is billed for each 15-minute increment of face-to-face interaction focused on protocol modification, highlighting the ongoing nature of adaptive behavior treatment in response to the patient's evolving needs.