The ABA CPT Code Family: 97151 Through 97158

Rates and coding references verified against the sources linked below. Updated September 2026.

CPT 97153 is the code that runs most ABA revenue: adaptive behavior treatment by protocol, delivered one-on-one by a technician, billed in 15-minute units. In our dataset of published state Medicaid fee schedules, it pays anywhere from $9.90 to $30.10 per unit depending on the state, with a $15.00 national median (see the full state-by-state ranking). But 97153 is one of eight codes in the ABA CPT family, running from the initial assessment (97151) to group protocol modification (97158), and each one has its own unit rule, its own billing credential, and its own place in your revenue mix. This page covers what each code means, the modifiers that change your rate, and the units math that trips up a budget built on a fee schedule.

This is a coding and billing reference for practice owners and billing staff. If you’re a parent trying to find out whether Medicaid covers your child’s ABA therapy, that question is answered on providerspark.com, not here.

The 8 CPT Codes, Plain English

Descriptors below are coding-reference summaries (source: AAPC’s CPT code library, cited per code); national medians are pulled from our own dataset of published state Medicaid fee schedules, the same dataset behind the rate hub.

The Two Codes Most Practices Never Bill

Two Category III codes round out the family for severe behavior cases: 0362T (a functional assessment of severe destructive behavior, performed with two or more technicians assisting a physician or qualified professional in a controlled environment) and 0373T (adaptive behavior treatment with protocol modification, delivered the same way, for a client whose behavior requires that staffing ratio). Both bill in 15-minute increments (0362T source, 0373T source). Coverage is inconsistent: Nevada, for example, caps combined treatment-code hours that include 0373T and restricts its telehealth billing, which tells you the state actively tracks it as a real, billable code, not a formality. Don’t assume your state covers either T-code until you’ve checked your own state’s fee schedule.

Modifiers: HO, HN, and HM Aren’t Universal

HCPCS modifiers HO, HN, and HM exist to tell a payer which credential level delivered a service: HO means master’s degree level, HN means bachelor’s degree level, and HM means less than bachelor’s degree level (HO, HN, HM). In ABA billing that usually maps to BCBA (HO), BCaBA (HN), and RBT or unlicensed technician (HM). Texas is a clean real-world example: its published schedule pays 97155 (HN), the BCaBA-delivered version, at $20.08 per 15-minute unit, and 97155 (HO), the BCBA-delivered version, at $25.10, a roughly 25% gap for the identical code based on credential alone.

Don’t assume every state uses this exact modifier set, though. Some states run credential tiers through provider specialty codes instead of HCPCS modifiers. Nevada assigns separate provider specialties (310 for LBA/BCBA, 311 for psychologist, 312 for BCaBA, 314 for RBT) and layers a UD modifier on top for BCaBA claims. California skips modifiers for credential tiering altogether and instead enrolls providers under two designations, QAS Provider (BCBA-level) and QAS Paraprofessional (technician-level), each with its own rate. And West Virginia pays a single flat rate for 97153 regardless of who delivers it. Bill the wrong modifier, or skip a required one, and the claim either underpays or bounces back. Check your own state’s provider manual for its specific crosswalk before you build a fee schedule into a revenue model.

Units Math: The 15-Minute Conversion Trap

Every code in the family bills in 15-minute units, which means the number on a fee schedule isn’t your hourly rate, it’s a quarter of it. To find the hourly equivalent, multiply the per-unit rate by 4. Nevada’s 97153 rate is a good stress test: $30.10 per 15-minute unit works out to $120.40 an hour, which is also the highest hourly-equivalent rate in our 51-jurisdiction dataset (see the full ranking). Run that same math on your own state’s rate before you build a technician pay scale or a caseload budget off the headline number.

The trap is that not every line item on a fee schedule uses the same structure. Some codes are priced per participant in a group setting rather than per client. Texas, for instance, holds its group codes (97158, both HN and HO tiers) at a flat rate billed per participant, separately from its individual codes, and that group rate rose at a different pace than the individual codes at the same rate review. If you’re modeling revenue off a schedule with both individual and group rows, read the unit column for each row individually. Don’t assume every code on the page scales the same way, and don’t assume a rate you saved six months ago is still the current one. Effective dates move, sometimes without much notice.

Which Code to Focus On for Revenue

97153 is the volume code for nearly every practice, since it covers the direct one-on-one treatment that makes up most billable hours. That’s where to start when you’re modeling revenue or setting technician pay. But 97155 and 97156 are the codes practices most often under-capture: supervision and family guidance are real, billable work that’s easy to deliver without documenting cleanly enough to bill for it. If your billing mix is almost entirely 97153 with a thin sliver of 97155 and 97156, that’s usually a documentation gap, not a sign your BCBAs aren’t doing supervision and family training. Pull your last quarter’s billing mix by code and compare it against what your BCBAs’ calendars actually show for supervision and caregiver sessions. The gap between the two is usually revenue you’re already earning but not billing for.

Check Your Own State’s Numbers

Every code above is a national reference point, not what you’ll actually get paid. Rates, modifiers, and even which codes require prior authorization vary by state and, in managed-care states, by MCO. Start with your own state’s fee schedule: Texas, Nevada, California, West Virginia, and Ohio are linked throughout this page as examples, or find your own state on the full state directory.

Frequently Asked Questions

Can I bill 97153 and 97155 on the same day?

In most states, yes, since they represent different services: direct treatment versus a BCBA’s supervision visit. But same-day billing rules, including whether both need separate documentation of medically necessary, non-overlapping time, vary by state and by MCO. Confirm the specific rule in your state’s provider manual before you bill both routinely on the same date of service.

What’s the real difference between 97153 and 97155?

97153 is treatment delivery, almost always billed by a technician working from an existing protocol. 97155 is the BCBA visit where that protocol gets reviewed and adjusted based on data. They’re billed by different credential levels and typically paid at different rates, with 97155 paying closer to twice the 97153 rate in most states in our dataset.

Can I bill 97152 separately from 97151?

They’re separate codes for separate work: 97151 is the BCBA-led assessment itself, and 97152 is additional technician-led data collection that supports it. Whether a payer reimburses both on the same claim, and how many units of each it allows, is a state-specific and often MCO-specific rule. Check your state’s fee schedule and prior authorization guidance for 97152 before you count on it as reliable revenue.

Which modifier do I use for an RBT versus a BCBA?

If your state uses the HO/HN/HM credential-tier system, HO applies to master’s-level staff (most BCBAs), HN to bachelor’s-level staff (most BCaBAs), and HM to technicians without a bachelor’s degree (most RBTs). Some states use a different system entirely, provider specialty codes, a separate modifier like UD, or flat rates that don’t vary by credential, so verify your state’s actual crosswalk rather than assuming HO/HN/HM applies everywhere.

Do all states publish separate rates for every code in the family?

No. Several states in our dataset only publish separate line items for the highest-volume codes, typically 97151, 97153, 97155, and 97156, and leave 97152, 97154, 97157, and 97158 undocumented or bundled. If your state’s published schedule doesn’t list a code you’re billing, contact your state Medicaid agency or MCO provider relations line directly rather than assuming a rate.

What happens if I bill the wrong unit type?

You either get underpaid or the claim gets denied outright. A 15-minute-unit code billed as if it were a per-session or hourly rate will either overstate or understate what you’re owed by a factor of roughly four, depending on which direction you get it wrong. Always confirm the unit definition on your specific state’s fee schedule line by line, since most rows are per 15 minutes but not all of them are.

Are 0362T and 0373T billable in every state?

No. Coverage for these two severe-behavior Category III codes is inconsistent across states, and even where they’re covered, states can apply extra restrictions, like hour caps or telehealth exclusions, that don’t apply to the core 97151-97158 codes. Check your own state’s fee schedule and billing guide before you plan a severe-behavior program around either code.