Connecticut Medicaid ABA Reimbursement Rates (2026)
From official Connecticut Medicaid sources. Updated July 2026.
These are the published Connecticut 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.
Connecticut ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 97153 | Adaptive behavior treatment by protocol, technician-delivered (technician tier) Stored $20.81 was wrong. Official CSV: $14.00 eff 1/1/2026 (ASD rate type; prior $12.17 from 11/17/2021). ASK enhanced rate (members <=20) has been $14.00 since 7/1/2024. Qty limit 72 units/day, PA required. | $14.00 | per 15 min | 2026-01-01 | source |
| 97156 | Family adaptive behavior treatment guidance / parent training without child (QHP tier: BCBA, LMFT, LPC, LCSW) Stored $25.50/eff 2025-01-01 was wrong. Added eff 7/1/2025 per PB 2025-30, published under ASK rate type at $21.20. 97156-U2 = parent training WITH child (same code family; CSV lists only the unmodified row). Limit 4 units/week; PA required from 9/1/2025. Not billable by behavior technicians. | $21.20 | per 15 min | 2025-07-01 | source |
| 97158 | Group adaptive behavior treatment by protocol (per participant) ASD rate type $3.08 eff 1/1/2026 (prior $2.97 from 11/17/2021; ASK $3.08 since 7/1/2024). Qty limit 16 units. PA required. | $3.08 | per 15 min | 2026-01-01 | source |
| H0031 | Behavior assessment by non-physician (CT’s ABA assessment code; 1 unit = 1 hour) $87.98 eff 1/1/2026 (prior $84.80). Up to 10 units initial / 6 concurrent per 6 months. PA required. Used instead of 97151. | $87.98 | per hour | 2026-01-01 | source |
| H0032 | Treatment plan (Plan of Care) development, untimed, 1 unit per plan $87.98 eff 1/1/2026 (prior $84.80). Quantity limit 1 without modifier. PA required. | $87.98 | per session | 2026-01-01 | source |
| H0032 (TS) | Program book development, untimed (H0032-TS) $60.70 eff 1/1/2026 (prior $58.51). Up to 3 units per 6 months. PA required. | $60.70 | per session | 2026-01-01 | source |
| H0046 | Observation & Direction of behavior technician (CT’s 97155 equivalent, QHP/BCBA tier) Per Carelon CT HUSKY ASD Services Grid: 1 unit = 15 minutes. $22.00 eff 1/1/2026 (prior $21.20). Qty 24 units. PA required. | $22.00 | per 15 min | 2026-01-01 | source |
| H2014 | Skills training and development – direct service delivery by BCBA/clinician (professional tier) CT’s professional-delivered treatment code (in lieu of 97153-HO type tiering). $15.24 eff 1/1/2026 (prior $14.69). Qty 75 units/day. PA required. | $15.24 | per 15 min | 2026-01-01 | source |
| T1016 | Case management (PPT meetings, discharge planning) by QHP Added eff 7/1/2025 per PB 2025-30, ASK rate type. First 96 units/24 hours per year without PA; PA required for unit 97+. | $11.33 | per 15 min | 2025-07-01 | source |
How Connecticut Compares
| Code | Connecticut | National median | Difference |
|---|---|---|---|
| 97153 | $14.00 | $15.00 | 7% below national median |
| 97156 | $21.20 | $22.50 | 6% below national median |
Market Context
Connecticut has had an autism insurance mandate since 2009. About 366,608 children in Connecticut are enrolled in Medicaid. Autism prevalence is 4.4% (2022 data). ProviderSpark lists 113 verified ABA provider locations in Connecticut.
Getting Paneled with HUSKY Health (Connecticut’s Medicaid/CHIP program)
Connecticut pays for ABA on a fee-for-service basis, but ASD/ABA credentialing and billing route through a separate administrative organization from the medical plan. Here’s the enrollment sequence:
- Register and complete the Provider Enrollment application in one sitting (progress can’t be saved) via the CMAP Enrollment Wizard at ctdssmap.com — save your Application Tracking Number (ATN).
- For enrollment questions, contact Gainwell Technologies, CT’s Medicaid fiscal agent, at 1-800-842-8440 or ctproviderenrollment@gainwelltechnologies.com.
- Submit your ASD clinical-qualification packet — DCF release form, letter of intent, resume/CV, diploma, license/BACB certificate, 2 behavior support plan samples, and proof of liability insurance — to Carelon Behavioral Health of CT.
- Wait for a qualification determination letter from Carelon, sent to you and to Gainwell, confirming which ASD services you’re approved to bill.
- Re-enroll on schedule: BCBAs every 2 years, other behavioral health clinicians every 5 years, each time with proof of active DPH license, current BACB certification, and an updated DCF background check form. Details on the qualification and re-enrollment process are on CT BHP’s ASD provider page.
How Connecticut Delivers ABA
HUSKY Health pays ABA fee-for-service — there are no managed care organizations administering the ABA benefit here. Behavioral health, including ASD/ABA, is carved out to its own administrative services organization, Carelon Behavioral Health of CT (operating as CT BHP), separate from the medical ASO (Community Health Network of CT / CHNCT) and the dental plan (Connecticut Dental Health Partnership). Your credentialing, prior authorization, and claims for ABA all go through Carelon/CT BHP specifically, not whichever ASO handles a client’s medical care. Because it’s fee-for-service rather than capitated managed care, your rate comes from a set state fee schedule rather than a plan-by-plan negotiated rate; we could not confirm the current reimbursement figures for this page.
Billing Notes
Prior authorization is required for ASD/ABA services, submitted through Carelon’s ProviderConnect portal using service-specific templates: Behavior Assessment/Treatment Plan/Program Book Development (codes ABA/APB), Direct Treatment Services (codes AOD/ABB/ASG/BA2), and Case Management beyond the standard benefit.
Telehealth is billable under the statewide CMAP telehealth policy (DSS Provider Bulletin PB 23-18, effective for dates of service on or after May 12, 2023, updated by PB 23-38), covering synchronized audio-visual visits and specified audio-only visits. CT BHP also publishes an ASD-specific telehealth fee schedule and FAQ. You’re required to keep the capacity to see clients in person and to do so when clinically appropriate or requested by the member.
One billing quirk to plan for: technicians delivering ABA — BCaBA, RBT, or otherwise qualified — must be directly observed by a qualified supervising Performing Provider for at least 10% of their direct-service time, with a separate observation-and-direction note tied to every claim. That’s a documentation step beyond what BACB’s general supervision guidance requires, and claims can be at risk if it’s skipped.
Common Questions
What does Connecticut Medicaid pay for CPT 97153?
Connecticut Medicaid pays $14.00 per 15 minutes for 97153 (direct treatment by a technician). That is about $56.00 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 Connecticut 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.
Compare neighboring states: New York · Massachusetts · Rhode Island