Kansas Medicaid ABA Reimbursement Rates (2026)
From official Kansas Medicaid sources. Updated July 2026.
These are the published Kansas 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.
Kansas ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 97151 | Behavior identification assessment (CCTS, PT 11 / specialty 403) Stored $23.00 eff 2024-07-01 was wrong. KMAP interactive rate lookup (TXIX, DOS 07/10/2026) shows MAX fee $43.75/unit, rate row eff 04/01/2019 through 12/31/2299. 1 unit = 15 min per KMAP Professional Manual. Ages 0-20 (KBH-EPSDT), PA required. | $43.75 | per 15 min | 2019-04-01 | source |
| 97152 | Behavior identification supporting assessment (CCTS, specialty 403) MAX fee $31.25/unit, eff 04/01/2019. | $31.25 | per 15 min | 2019-04-01 | source |
| 97153 | Adaptive behavior treatment by protocol (IIS technician, PT 11 / specialty 404) Stored $12.25 was wrong. Current MAX fee $16.25/unit, rate row eff 07/01/2024. Billable by specialty 404 (IIS) and, since 7/1/2024, also specialty 403 (CCTS). Soft limit 25 hrs/week initially. | $16.25 | per 15 min | 2024-07-01 | source |
| 97154 | Group adaptive behavior treatment by protocol, technician (IIS specialty 404; also 403 since 7/1/2024) MAX fee $8.35/unit, rate row eff 01/01/2019. Coverage under IIS added eff 7/1/2024; priced per participant per 15 min. | $8.35 | per 15 min | 2019-01-01 | source |
| 97155 | Adaptive behavior treatment w/ protocol modification (CCTS, specialty 403) Stored $20.00 eff 2024-07-01 was wrong. Current MAX fee $24.00/unit, rate row eff 04/01/2019 through 12/31/2299. | $24.00 | per 15 min | 2019-04-01 | source |
| 97156 | Family adaptive behavior treatment guidance (CCTS, specialty 403) MAX fee $37.50/unit, rate eff 04/01/2019 through 12/31/2299, verified in KMAP interactive lookup for DOS 07/10/2026. | $37.50 | per 15 min | 2019-04-01 | source |
| 97158 | Group adaptive behavior treatment w/ protocol modification (CCTS, specialty 403) MAX fee $8.35/unit, rate row eff 01/01/2019; code coverage for specialty 403 added eff 7/1/2024. Not covered for specialty 404. | $8.35 | per 15 min | 2019-01-01 | source |
How Kansas Compares
| Code | Kansas | National median | Difference |
|---|---|---|---|
| 97151 | $43.75 | $29.14 | 50% above national median |
| 97153 | $16.25 | $15.00 | 8% above national median |
| 97155 | $24.00 | $24.18 | 1% below national median |
| 97156 | $37.50 | $22.50 | 67% above national median |
Market Context
Kansas has had an autism insurance mandate since 2010. About 278,035 children in Kansas are enrolled in Medicaid. Autism prevalence is 3.3% (2022 data). ProviderSpark lists 44 verified ABA provider locations in Kansas.
Getting Paneled with KanCare (Kansas’s statewide Medicaid managed care program)
Kansas runs its Medicaid autism ABA benefit entirely through managed care, so KMAP enrollment is only step one — you still need to credential separately with each plan before you can bill a member seen through it.
- Gather your documents: a completed Behavioral Interventions Attestation form; for CCTS (BCBA-level) providers, your KS BSRB license and BACB certification proof (or, for master’s-level applicants, a KDADS HCBS-signed letter); for IIS (technician-level) providers, your RBT certificate or a KDADS HCBS-signed letter documenting the alternative training pathway; proof of malpractice/liability insurance; a Tax ID/EIN/SSN plus W-9; and an NPI (Type 1 for individuals, Type 2 for the group). See Optum’s Kansas ABA authorization guide.
- Enroll the group first through the KMAP Provider Enrollment Wizard to get a KMAP ID, then enroll each practitioner “Individual within a Group” under Provider Type 11 (Mental Health Provider), Specialty 403 (CCTS) or 404 (IIS). Solo practitioners billing under a Type 1 NPI choose “Individual.” Each service location needs its own enrollment.
- Wait for KMAP to screen and approve the application (KMAP support line: 1-800-933-6593).
- Once approved, credential and contract separately with each KanCare MCO you want to bill through — for example, call Optum Behavioral Health at 1-877-614-0484 for UnitedHealthcare Community Plan credentialing, and repeat with Sunflower and Healthy Blue for full KanCare reach.
- Re-enroll every new hire (ABA or RBT) through KMAP under their own NPI, and re-enroll for any additional location, before billing for their work.
How Kansas Delivers ABA
KanCare is fully managed-care: Sunflower Health Plan (a Centene company), UnitedHealthcare Community Plan of Kansas (ABA network run through affiliate Optum Behavioral Health), and Healthy Blue Kansas (new for the 2025–2027 cycle, replacing Aetna Better Health of Kansas as of January 1, 2025). There’s no fee-for-service fallback for this benefit, so the rate you’re actually paid depends on which plan’s contract you sign, not a single state fee schedule. KMAP enrollment gets you into the system, but each MCO negotiates and pays separately — providers report MCO credentialing as the slowest step, with Optum alone taking up to 90 days from enrollment to a signed contract.
Billing Notes
Prior authorization is required. Sunflower’s KanCare clinical policy (KS.CP.01) requires a completed Autism Authorization Request Form plus supporting documentation before initial authorization: an ASD-confirming psychological evaluation within 6 months, a criterion-referenced assessment (Vineland-III, ADOS, CARS, ADI-R, GARS, or ASDS), a skills-based assessment (VB-MAPP, ABLLS, AFLS, or ASRS), a recent Kan Be Healthy screening, and a treatment plan specifying focused (10–25 hrs/wk) or comprehensive (25–40 hrs/wk) hours. Continuation needs a review every 3–6 months and an annual reassessment. See Sunflower’s ABA clinical policy.
Telehealth is not an option for direct 1:1 ABA treatment. KMAP discontinued telephonic/telehealth coverage for the core CCTS and IIS billing codes effective May 11, 2023, so assessment and direct-treatment services must be delivered in person now.
The billing quirk to plan around: nothing bills until the chain is complete. The group must be KMAP-enrolled before any staff member can bill, every new hire needs their own KMAP enrollment, enrollment is location-specific, and KMAP approval alone doesn’t unlock revenue — you still need a signed contract with each MCO whose members you’re seeing.
Common Questions
What does Kansas Medicaid pay for CPT 97153?
Kansas Medicaid pays $16.25 per 15 minutes for 97153 (direct treatment by a technician). That is about $65.00 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 Kansas 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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