Maryland Medicaid ABA Reimbursement Rates (2026)
From official Maryland Medicaid sources. Updated July 2026.
These are the published Maryland 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.
Maryland ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 0362T | Exposure behavior identification supporting assessment (2+ techs w/ BCBA onsite) Daily max 32 units. BCBA-level supervisor must be onsite. | $52.28 | per 15 min | 2026-02-01 | source |
| 0373T | Exposure adaptive behavior treatment w/ protocol modification (2+ techs w/ BCBA onsite) Daily max 24 units. BCBA-level supervisor must be onsite. | $52.28 | per 15 min | 2026-02-01 | source |
| 97151 | Behavior identification assessment incl. treatment planning (Psychologist/BCBA-D/BCBA) Daily max 32 units. Rate in effect since 7/1/2024. | $38.34 | per 15 min | 2026-02-01 | source |
| 97152 | Behavior identification supporting assessment (BCaBA/RBT/BT) Daily max 32 units. | $19.17 | per 15 min | 2026-02-01 | source |
| 97153 | Adaptive behavior treatment by protocol (RBT/BT) Was $18.61 eff 1/1/2024; increased to $19.17 eff 7/1/2024 (FY25) and unchanged through the 2/1/2026 manual. State schedule no longer uses a practitioner modifier for this tier. | $19.17 | per 15 min | 2026-02-01 | source |
| 97154 | Group adaptive behavior treatment by protocol (Psychologist/BCBA-D/BCBA) Priced PER ABA participant. Group limited to 2-8 participants. Daily max 16 units. | $10.45 | per 15 min | 2026-02-01 | source |
| 97155 | Adaptive behavior treatment w/ protocol modification/direction (Psychologist/BCBA-D/BCBA) Was stored as modifier HO $37.22. Current rate $38.34 since 7/1/2024. Single tier (BCBA-level only). GT modifier = remote direction of technician via telehealth. Daily max 24 units. | $38.34 | per 15 min | 2026-02-01 | source |
| 97156 | Family adaptive behavior treatment guidance WITHOUT child present (BCaBA) Rate unchanged from stored value but stored HN modifier no longer used; this is the without-child-present rate. With child present bills U2 at $20.91 for BCaBA. Daily max 16 units. | $12.21 | per 15 min | 2026-02-01 | source |
| 97156 (U2) | Family adaptive behavior treatment guidance WITH child present (Psychologist/BCBA-D/BCBA) U2 modifier signifies child present. Daily max 16 units. | $38.34 | per 15 min | 2026-02-01 | source |
| 97157 | Multiple-family group adaptive behavior treatment guidance (Psychologist/BCBA-D/BCBA) Priced PER FAMILY. Group limited to 2-8 families. Daily max 10 units. Telehealth allowed w/ GT. | $12.91 | per 15 min | 2026-02-01 | source |
| 97158 | Group adaptive behavior treatment w/ protocol modification (Psychologist/BCBA-D/BCBA) Priced PER ABA participant. Group limited to 2-8 participants. Daily max 10 units. | $10.45 | per 15 min | 2026-02-01 | source |
| H2012 | Adaptive behavior treatment planning (Psychologist/BCBA-D/BCBA) On Carelon FY26 fee schedule (eff 7/1/2025, max 4 units/day, 16/month, 96 per 6-mo auth) but ABSENT from the fee table in the MDH provider manual eff 2/1/2026 — may be phased out; verify before relying on it. | $38.34 | per 15 min | 2025-07-01 | source |
How Maryland Compares
| Code | Maryland | National median | Difference |
|---|---|---|---|
| 97151 | $38.34 | $29.14 | 32% above national median |
| 97153 | $19.17 | $15.00 | 28% above national median |
| 97155 | $38.34 | $24.18 | 59% above national median |
| 97156 | $12.21 | $22.50 | 46% below national median |
Market Context
Maryland has had an autism insurance mandate since 2000. About 671,744 children in Maryland are enrolled in Medicaid. Autism prevalence is 3.6% (2022 data). ProviderSpark lists 284 verified ABA provider locations in Maryland.
Getting Paneled with Maryland Medicaid
Maryland Medicaid has covered ABA as an Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for enrollees under age 21 since January 1, 2017. Getting paneled means working through a specific sequence of state systems before you can bill:
- Enroll with Maryland Medicaid through the electronic Provider Revalidation and Enrollment Portal (ePREP) — required for every ABA provider type, from licensed psychologists down to BTs.
- Register with the Behavioral Health Administrative Service Organization (BHASO) — Carelon Behavioral Health of Maryland, which took over as the ASO from Optum Maryland on January 1, 2025 and manages ABA prior authorization and claims.
- If you’re a licensed psychologist providing ABA, complete the ABA Attestation Form on the MDH ABA program page.
- For Behavior Technicians specifically: enroll in ePREP under specialty code 325 with “BT” as the license number and a high school diploma attached, then submit RBT certification proof through ePREP within the 90-day grace period.
- It’s recommended, though not required, that newly enrolled ABA groups attend a virtual Meet and Greet with Carelon in their first three months in-network to review ABA benefit expectations.
How Maryland Delivers ABA
Maryland runs ABA as straight fee-for-service, not managed care. There’s no MCO to shop between or negotiate with — your rate comes off a single statewide fee schedule, and every claim routes through the BHASO (Carelon) rather than a health plan. Your reimbursement is fixed by policy, not by which plan a given family happens to be enrolled in.
Billing Notes
Every ABA service needs prior authorization from Carelon, valid for a maximum of 180 days before reassessment and reauthorization. Before Carelon will authorize anything, a Qualified Health Care Professional (developmental pediatrician, pediatrician, pediatric neurologist, child psychiatrist, clinical psychologist, neuropsychologist, or nurse practitioner) must complete a Comprehensive Diagnostic Evaluation confirming an ASD diagnosis, then a psychologist, BCBA-D, or BCBA must complete an assessment and detailed treatment plan using the required template.
Telehealth is only partially reimbursable. Just three codes qualify over two-way, HIPAA-compliant audio-visual telehealth: supervision/direction of a BCaBA/RBT/BT (97155), family adaptive behavior treatment guidance (97156), and multiple-family group guidance (97157) — billed with the GT modifier and Place of Service 11. Direct 1:1 treatment to the child (97153) can’t be billed via telehealth at all, and since October 16, 2023, requesting telehealth on an eligible code also requires a Telehealth Readiness Checklist in the treatment plan.
One quirk to plan around: BCaBAs, RBTs, and BTs can never bill Maryland Medicaid directly, even for services they personally delivered. All claims go through an enrolled ABA group or an individual provider — a licensed psychologist, BCBA-D, or BCBA — who submits to the BHASO on the technician’s behalf.
Common Questions
What does Maryland Medicaid pay for CPT 97153?
Maryland Medicaid pays $19.17 per 15 minutes for 97153 (direct treatment by a technician). That is about $76.68 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 Maryland 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: Virginia · District of Columbia · Pennsylvania · Delaware · West Virginia