Number of Pages: 2

Who is it for?

• BCBA or qualifying ABA health providers 

What is it?

• This is a template specifically designed for documenting activities during supervision sessions (CPT Code: 97155 or 97158)

• This template includes sections for documenting:

  • Programs modifications

  • Observation of BT's implemented programs and provision of feedback 

  • Program/procedure reviewed/modeled 

  • Procedural fidelity check

  • IOA

  • Behavior data 

  • BT's questions addressed

  • Feedback delivered to BT

  • Planning/follow up actions

  • New Program added

  • Session summary

  • Session notes approval signature 

Why should you use it?

• Documenting billable activities is required by most insurance payors

• This template includes components that are generally audited by the payors

**Disclaimer: It is the user's responsibility to verify with the payor the type of information required in clinical documentation. While our template has coponents that are generally audited by the payors, we cannot guarantee it will meet the requirements by all the payors.