Mississippi Medicaid ABA Reimbursement Rates (2026)
From official Mississippi Medicaid sources. Updated July 2026.
These are the published Mississippi 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.
Mississippi ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 0362T | Behavior identification supporting assessment, each 15 min (Category III) Legacy Category III code still priced on official schedule; PA required | $56.64 | per 15 min | 2025-12-01 | source |
| 0373T | Adaptive behavior treatment with protocol modification, each 15 min (Category III) Legacy Category III code still priced on official schedule; PA required | $41.49 | per 15 min | 2025-12-01 | source |
| 97151 | Behavior identification assessment by physician/QHP Verified in May 2026 ASD fee schedule; begin date 05/01/2020, end 12/31/2299; no PA flag; ages 0-20; MUE max units | $34.18 | per 15 min | 2020-05-01 | source |
| 97152 | Behavior identification supporting assessment by one technician On official schedule; PA required; unchanged since 07/01/2019 | $41.74 | per 15 min | 2019-07-01 | source |
| 97153 | Adaptive behavior treatment by protocol (technician) Stored $13.77 is outdated; current schedule shows $15.08 effective 12/01/2025. PA required; ages 0-20 | $15.08 | per 15 min | 2025-12-01 | source |
| 97154 | Group adaptive behavior treatment by technician Group code, priced per participant per 15 min; PA required | $9.42 | per 15 min | 2025-12-01 | source |
| 97155 | Adaptive behavior treatment with protocol modification by physician/QHP Verified in May 2026 ASD fee schedule; PA required; ages 0-20 | $24.35 | per 15 min | 2025-12-01 | source |
| 97156 | Family adaptive behavior treatment guidance by physician/QHP Verified in May 2026 ASD fee schedule; PA required; ages 0-20 | $24.35 | per 15 min | 2025-12-01 | source |
| 97157 | Multiple-family group adaptive behavior treatment guidance by physician/QHP Group code, priced per participant per 15 min; PA required | $12.17 | per 15 min | 2025-12-01 | source |
| 97158 | Group adaptive behavior treatment with protocol modification by physician/QHP Group code, priced per participant per 15 min; PA required | $12.17 | per 15 min | 2025-12-01 | source |
How Mississippi Compares
| Code | Mississippi | National median | Difference |
|---|---|---|---|
| 97151 | $34.18 | $29.14 | 17% above national median |
| 97153 | $15.08 | $15.00 | 1% above national median |
| 97155 | $24.35 | $24.18 | 1% above national median |
| 97156 | $24.35 | $22.50 | 8% above national median |
Market Context
Mississippi has had an autism insurance mandate since 2015. About 394,291 children in Mississippi are enrolled in Medicaid. Autism prevalence is 1.8% (2022 data). ProviderSpark lists 41 verified ABA provider locations in Mississippi.
Getting Paneled with Mississippi Medicaid – Autism Spectrum Disorder (ASD) Services (Division of Medicaid), authorized under State Plan Amendment 16-0020 (effective 1/1/2017)
Mississippi’s ASD benefit runs through State Plan Amendment 16-0020, and getting paid means clearing both a state licensing step and a Medicaid enrollment step before you ever bill a claim:
- Obtain MS Autism Board licensure as a Behavior Analyst (LBA) or Assistant Behavior Analyst (LaBA); LBA applicants must also pass the oral jurisprudence exam.
- Confirm or obtain an NPI through NPPES.
- Enroll as a Mississippi Medicaid provider through the MESA provider portal (Gainwell Technologies is the fiscal agent).
- Register any RBTs or behavior technicians with the MS Autism Board under your supervising license before they deliver billable services.
- Separately credential with each MississippiCAN MCO — Magnolia, Molina, and TrueCare — to bill their managed-care ASD members.
How Mississippi Delivers ABA
Mississippi runs ASD services as a hybrid: some claims go through fee-for-service, and others route through MississippiCAN managed care organizations — Magnolia Health Plan (Centene), Molina Healthcare of Mississippi, and Mississippi True d/b/a TrueCare. That split means one state enrollment doesn’t cover you everywhere. If a chunk of your caseload carries MississippiCAN coverage, you need a separate contract with that member’s specific MCO to actually get paid for their sessions, on top of your fee-for-service enrollment.
Billing Notes
Every ASD/ABA service needs prior authorization as medically necessary. For fee-for-service claims, Alliant Health Solutions has handled that utilization review since 8/1/2019; for MississippiCAN members, the prior auth goes through the member’s own MCO instead.
Telehealth is only partly covered. Mississippi’s telehealth rule (Title 23, Part 225, Chapter 1, Rule 1.3.B.2.h, revised 2/1/2024) names BCBAs and BCBA-Ds as eligible distant-site telehealth providers — BCaBAs and RBTs are not listed, so telehealth reimbursement for direct RBT-delivered sessions is unconfirmed under this rule.
On billing itself, SPA 16-0020 is explicit: licensed practitioners assume professional responsibility for services delivered by unlicensed practitioners (RBTs and BCaBAs), and licensed practitioners are the ones who bill Medicaid for that work — a technician can’t submit their own claim. Claims tied to a technician who wasn’t registered with the MS Autism Board first are also at risk.
Common Questions
What does Mississippi Medicaid pay for CPT 97153?
Mississippi Medicaid pays $15.08 per 15 minutes for 97153 (direct treatment by a technician). That is about $60.32 per hour.
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 Mississippi 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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