Georgia Medicaid ABA Reimbursement Rates (2026)
From official Georgia Medicaid sources. Updated July 2026.
These are the published Georgia Medicaid rates for applied behavior analysis (ABA) services. Rates are shown as published. For per-15-minute rows, multiply by 4 for the hourly rate; rows priced per hour, per session, or per assessment are labeled in the table.
Georgia ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 97151 (U1 U6) | Behavior identification assessment (Level 1 Physician/Psychiatrist, in-clinic) U1 out-of-clinic = 76.31. | $59.96 | per 15 min | 2025-10-08 | source |
| 97151 (U2 U6) | Behavior identification assessment (Level 2 Psychologist/BCBA-D, in-clinic) U2 out-of-clinic = 48.16. | $40.14 | per 15 min | 2025-10-08 | source |
| 97151 (U3 U6) | Behavior identification assessment (Level 3 BCBA, in-clinic) Rate verified exactly; added GA’s required service-location modifier U6 (in-clinic). GT telehealth pays same rate. | $30.91 | per 15 min | 2025-10-08 | source |
| 97151 (U3 U7) | Behavior identification assessment (Level 3 BCBA, out-of-clinic) Out-of-clinic (U7) setting pays higher than in-clinic. | $37.78 | per 15 min | 2025-10-08 | source |
| 97153 (U3 U6) | Adaptive behavior treatment by protocol (Level 3 BCBA, in-clinic) Rate verified exactly; added location modifier U6. GT same rate. | $30.91 | per 15 min | 2025-10-08 | source |
| 97153 (U3 U7) | Adaptive behavior treatment by protocol (Level 3 BCBA, out-of-clinic) | $37.78 | per 15 min | 2025-10-08 | source |
| 97153 (U4 U6) | Adaptive behavior treatment by protocol (Level 4 BCaBA, in-clinic) U4 out-of-clinic = 25.09. | $20.91 | per 15 min | 2025-10-08 | source |
| 97153 (U5 U6) | Adaptive behavior treatment by protocol (Level 5 RBT, in-clinic) Rate verified exactly; added location modifier U6. GT same rate. | $15.58 | per 15 min | 2025-10-08 | source |
| 97153 (U5 U7) | Adaptive behavior treatment by protocol (Level 5 RBT, out-of-clinic) | $18.69 | per 15 min | 2025-10-08 | source |
| 97154 (U5 U6) | Group adaptive behavior treatment by protocol (Level 5 RBT, in-clinic) Fee schedule does not state per-participant pricing; U5 out-of-clinic = 18.69. | $15.58 | per 15 min | 2025-10-08 | source |
| 97155 (U3 U6) | Adaptive behavior treatment w/ protocol modification (Level 3 BCBA, in-clinic) Rate verified exactly; added location modifier U6. GT same rate. Payable U1-U3 only. | $30.91 | per 15 min | 2025-10-08 | source |
| 97155 (U3 U7) | Adaptive behavior treatment w/ protocol modification (Level 3 BCBA, out-of-clinic) | $37.78 | per 15 min | 2025-10-08 | source |
| 97156 (U3 U6) | Family adaptive behavior treatment guidance (Level 3 BCBA, in-clinic) Rate verified exactly; added location modifier U6. GT same rate. Payable U1-U3 only. | $13.61 | per 15 min | 2025-10-08 | source |
| 97156 (U3 U7) | Family adaptive behavior treatment guidance (Level 3 BCBA, out-of-clinic) | $17.01 | per 15 min | 2025-10-08 | source |
| 97158 (U3 U6) | Group adaptive behavior treatment w/ protocol modification (Level 3 BCBA, in-clinic) U3 out-of-clinic = 17.01; payable U1-U3 only. | $13.61 | per 15 min | 2025-10-08 | source |
How Georgia Compares
| Code | Georgia | National median | Difference |
|---|---|---|---|
| 97151 (U1 U6) | $59.96 | $29.14 | 106% above national median |
| 97153 (U3 U6) | $30.91 | $15.00 | 106% above national median |
| 97155 (U3 U6) | $30.91 | $24.18 | 28% above national median |
| 97156 (U3 U6) | $13.61 | $22.50 | 40% below national median |
Market Context
Georgia has had an autism insurance mandate since 2001. About 1,322,796 children in Georgia are enrolled in Medicaid. Autism prevalence is 3.1% (2022 data). ProviderSpark lists 392 verified ABA provider locations in Georgia.
Getting Paneled with Georgia Medicaid Adaptive Behavior Services
Georgia Medicaid runs its ABA benefit as Adaptive Behavior Services under DCH, Division of Medicaid, with a portion of members routed through the managed-care umbrella Georgia Families. Only a Georgia-licensed LBA (or an enrolled physician or psychologist) with current BACB certification can enroll as the billing provider — BCaBAs and RBTs bill under that provider’s number, not their own. Enrollment runs through these steps:
- Confirm you hold your Georgia LBA and current BCBA/BCBA-D certification — see the ASD Services Policy Manual for who qualifies as the enrolled Qualified Health Care Professional.
- Complete Georgia Medicaid provider enrollment through the GAMMIS Enrollment Wizard, individually under taxonomy 103K00000X (Behavior Analyst) or as a group/billing provider for agencies. A complete individual application takes about 15 business days.
- Submit the ASD Services Attestation form to DCH ABS Enrollment, naming every supervised BCaBA and RBT and their one-year experience attestation. Required at initial enrollment and again within 2 weeks of any staffing change.
- If you’ll serve members in a Georgia Families plan rather than fee-for-service, separately credential and contract with that care management organization (CMO) — each runs its own enrollment and prior-authorization process.
- Review the current ASD Services Manual and fee schedule before billing, including telehealth (GT-modifier) rates.
How Georgia Delivers ABA
Georgia runs a hybrid model: some members are fee-for-service through DCH directly, and others are enrolled in a Georgia Families CMO plan, currently Amerigroup Community Care, CareSource, or Peach State Health Plan (Centene). Which bucket a client falls into changes your workflow — CMO members need separate credentialing and prior authorization with that plan, on top of DCH enrollment. Georgia’s managed-care roster is also set to shift: DCH has issued a notice of intent to award the next Georgia Families contract to CareSource, Humana, Molina, and UnitedHealthcare, with Amerigroup and Peach State expected to exit around January 2027. Re-verify the active CMO list closer to when you enroll.
Billing Notes
Prior authorization is required for essentially all covered services, issued in 6-month increments. The Behavioral Assessment needs its own PA (capped at 8 hours per 6 months unless justified further), and Treatment Services need a separate PA, with weekly hours (typically 10 to 30) set by medical necessity. Some service allotments are further split into 28-day periods within the 6-month authorization and don’t carry over if unused, so plan utilization accordingly.
Telehealth is billable using the GT modifier with place-of-service code 02, and the fee schedule publishes GT-modifier rates alongside in-clinic and out-of-clinic rates for most ABA codes. Current CareSource policy restricts telehealth billing to providers physically in Georgia or within 50 miles of the border at time of service, and telehealth must be appropriate for the member, not used as the primary treatment method.
Common Questions
What does Georgia Medicaid pay for CPT 97153?
See the rate table above for the codes Georgia publishes.
What are the main ABA CPT codes?
97151 is the assessment. 97153 is direct treatment by a technician. 97155 is treatment with protocol modification by the BCBA. 97156 is family guidance.
Are these Georgia rates current?
Rates come from the state fee schedule and were last checked July 2026. Each row links to its source. Always confirm against the current fee schedule before billing.
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