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Adding Overlapping Restrictions

This section is most relevant to billing administrators, schedulers, and contract managers who need to enforce service-level or authorization-level rules to prevent overlapping sessions and ensure compliance with contract and payer requirements.

Each contract may specify certain services that cannot overlap. The Overlapping Restrictions tab allows you to define these rules, which the system enforces during scheduling and billing.

What Are Overlapping Restrictions?
Overlapping restrictions are system-enforced safeguards that:

  • Prevent multiple sessions from being scheduled for the same client or provider at the same time

  • Ensure compliance with payer rules that prohibit overlapping billing codes or authorizations

  • Avoid provider overbooking or double-booking across clients or services

Examples of When to Use:

  • Client-Level Restrictions:
    A client cannot have a 97153 (1:1 ABA) session and a 97155 (supervision or direction) session scheduled at the same time, unless permitted by the funder.

  • Authorization-Level Restrictions:
    The same CPT code may not be billable across overlapping time windows if prohibited by the payer.

What Happens When Overlapping Restrictions Are Triggered?

  • A hard stop may prevent session entry or scheduling

  • A warning may appear notifying the user of a conflict

  • The session may fail claims validation or be marked as non-billable according to contract/funder rules

Adding Overlapping Restrictions:

  1. In the upper-right corner, click the Add Restrictions button.

  2. In the popup, select the two services that cannot be scheduled at the same time (i.e., overlap).

  3. Enter the start and end dates for the restriction.

  4. Click Save to enforce the rule.

overlapping

Last Updated: 12/19/2025 by Tiffany McLean