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.