This is the actual code that is selected in TotalABA and sent in billing messages from a session. Examples of CPT codes include: 96151, 0360T, etc.

Indicates if the procedure code is active in TotalABA. If it is active, it means it may be selected on an authorization, in a session, etc.

Indicates the type of procedure code. CPT codes are used by insurance, if your practice utilizes MRC then CPT codes may only be maintained by them.

May be used to help categorize the various procedure codes in your site.

If a modifier code should always be associated to the procedure code when selected on a session, select the modifier here.

This is the explanation of the code.

Used to indicate the number of minutes required to automatically calculate a unit for the procedure. For example, if the minutes per unit are 15 and the duration is 45 minutes, then 3 units are calculated. See the Rounding Method field for further details on how units are calculated when the minutes per unit are not evenly divisible by the duration.

If a value is entered then this indicates the maximum number of minutes that may be applied to the procedure on the session. Any additional minutes must be applied to other procedures. This only is used when the minutes per unit on the procedure also has a value.

Used to indicate the number of units that should always be used for the procedure code on a session, regardless of the time spent for that procedure. This must be 0 if minute per unit has a value greater than 0.

Indicates the maximum # of units that may be signed-off on sessions for a given day for the student. If the maximum is exceeded, then you will not be able to sign-off on the session(s).

• • Full Units, Rounded Down – The procedure code will always have a whole number for the units. Any fractions that result from the duration divided by the minutes per unit will be rounded down. For example:

    • If the minutes per unit is 15 and the duration is 15 - 29 minutes, then 1 unit is calculated.

    • If the duration is 30 – 44 minutes, then 2 units are calculated.

    • If the duration is less than the minutes per unit, then 0 units are calculated.

  • Full Units, Greater Than 50% - The procedure code will always have a whole number for the units. Any fractions that result from the duration divided by the minutes per unit will be rounded up or down depending on if the fraction is greater than 0.5. For example:

    • If the minutes per unit is 30 and the duration is 16 - 29 minutes, then 1 unit is calculated.

    • If the duration is 31 – 45 minutes, then 1 unit is still calculated. If the duration is 46 – 60 minutes, then 2 units are calculated.

    • If the duration is less or equal to half the minutes per unit, then 0 units are calculated (e.g. 15 minutes or less in the current example).

  • Full Units, Rounded Up – The procedure code will always have a whole number for the units. Any fractions that result from the duration divided by the minutes per unit will be rounded up. For example:

    • If the minutes per unit is 15 and the duration is 1 - 15 minutes, then 1 unit is calculated.

    • If the duration is 16 - 30 minutes, then 2 units are calculated.

    • If the duration is 0, then 0 units are calculated.

  • Partial Units, Round Down – This option allows for fractional units for the procedure on the session. It is only allowed when the minutes per unit are either 30 or 60. If 30 minutes per unit is used, then half units are calculated (e.g. 0.5, 1, 1.5, etc.). If 60 minutes per unit is used, then quarter units are calculated (e.g. 0.25, 0.5, 0.75, 1, 1.25, etc.). Some examples:

    • If the minutes per unit is 30 and the duration is 0 - 14 minutes, then 0 units are calculated.

    • If the minutes per unit is 30 and the duration is 15 - 29 minutes, then 0.5 units are calculated.

    • If the minutes per unit is 60 and the duration is 0 - 14 minutes, then 0 units are calculated.

    • If the minutes per unit is 60 and the duration is 15 - 29 minutes, then 0.25 units are calculated.

    • If the minutes per unit is 60 and the duration is 30 - 44 minutes, then 0.5 units are calculated.

    • If the minutes per unit is 60 and the duration is 45 - 59 minutes, then 0.75 units are calculated.

The secondary code is used to automatically set a second procedure code when the primary code is selected. For example, on procedure 0360T the secondary code should be 0361T. When 0360T is selected on a session, then 0361T is automatically added as a procedure to that session as well. The primary procedure code automatically will have duration up the maximum duration. The secondary code will receive the remaining billable minutes from the session.

If your practice is using MRC Billing, then they will maintain the list of all applicable CPT (insurance) procedure codes in the practice. If additional codes are required or there are questions regarding the existing codes, please contact MRC.