Montana Medicaid ABA Reimbursement Rates (2026)
From official Montana Medicaid sources. Updated July 2026.
These are the published Montana 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.
Montana ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 97151 | Behavior identification assessment by professional (BCBA) Verified in July 2025 ABA fee schedule PDF. Assessment authorization: package of 1,260 units across all codes over 180 days. July 2026 update announced for ABA but new schedule not yet published as of 2026-07-10. | $40.41 | per 15 min | 2025-07-01 | source |
| 97151 (TC) | Behavior identification assessment by intermediate professional (BCaBA) Verified in July 2025 ABA fee schedule PDF. Montana uses modifier TC for the BCaBA/intermediate tier. | $29.91 | per 15 min | 2025-07-01 | source |
| 97152 | Behavior identification supporting assessment by technician Published on July 2025 ABA fee schedule; we lacked this row. | $11.36 | per 15 min | 2025-07-01 | source |
| 97153 | Adaptive behavior treatment by protocol, technician (RBT) Verified in July 2025 ABA fee schedule PDF. | $11.36 | per 15 min | 2025-07-01 | source |
| 97154 | Group adaptive behavior treatment by protocol, technician, multiple patients Published on July 2025 ABA fee schedule. Flat per-15-min rate; schedule does not state per-participant pricing. | $3.78 | per 15 min | 2025-07-01 | source |
| 97155 | Adaptive behavior treatment with protocol modification, professional (BCBA) Verified in July 2025 ABA fee schedule PDF. | $20.46 | per 15 min | 2025-07-01 | source |
| 97155 (TC) | Adaptive behavior treatment with protocol modification, intermediate professional (BCaBA) Verified in July 2025 ABA fee schedule PDF. | $15.17 | per 15 min | 2025-07-01 | source |
| 97156 | Family adaptive behavior treatment guidance (BCBA or BCaBA) Verified in July 2025 ABA fee schedule PDF. Same rate for BCBA and BCaBA; no TC split on this code. | $20.46 | per 15 min | 2025-07-01 | source |
| 97157 | Multiple-family group adaptive behavior treatment guidance (BCBA or BCaBA) Published on July 2025 ABA fee schedule; we lacked this row. | $6.84 | per 15 min | 2025-07-01 | source |
| 97158 | Group adaptive behavior treatment with protocol modification (BCBA or BCaBA) Published on July 2025 ABA fee schedule; we lacked this row. | $6.84 | per 15 min | 2025-07-01 | source |
How Montana Compares
| Code | Montana | National median | Difference |
|---|---|---|---|
| 97151 | $40.41 | $29.14 | 39% above national median |
| 97153 | $11.36 | $15.00 | 24% below national median |
| 97155 | $20.46 | $24.18 | 15% below national median |
| 97156 | $20.46 | $22.50 | 9% below national median |
Market Context
Montana has had an autism insurance mandate since 2009. About 91,101 children in Montana are enrolled in Medicaid. Autism prevalence is 3.2% (2022 data). ProviderSpark lists 7 verified ABA provider locations in Montana.
Getting Paneled with Montana Medicaid (Montana Healthcare Programs); ABA is administered as an EPSDT-adjacent service by the DPHHS Behavioral Health and Developmental Disabilities Division (Developmental Disabilities Program)
Montana runs ABA benefits straight out of a state agency, not a managed-care plan. The Behavioral Health and Developmental Disabilities Division’s Developmental Disabilities Program administers the service, and enrollment goes through the state’s own provider system:
- Determine your enrollment type (individual/rendering provider vs. organizational/group provider) by contacting Provider Relations at (800) 624-3958 or MTEnrollment@conduent.com
- Complete the online application in the ICAP Provider Services Portal, including your tax ID, ownership, and BACB certification info
- Mail your Provider Enrollment Agreement, W-9, EFT Authorization, disclosures, and license/BACB certification copies using the Montana Provider Services Mail Cover Sheet to PO Box 89, Great Falls, MT 59403
- Wait for a welcome letter from Provider Relations confirming your enrollment is active, which includes your NPI (or Atypical Provider Identifier)
- Register for the MATH Web Portal for claims and eligibility, and review the ABA-specific manual, fee schedule, and required forms
How Montana Delivers ABA
Montana pays for ABA fee-for-service — there’s no managed care organization standing between you and the state on this benefit. That means the rate you get paid isn’t negotiated with a private plan; it’s whatever the Department’s published fee schedule says. Montana uses an RBRVS (Resource-Based Relative Value Scale) fee schedule for ABA, updated twice a year on a January 1 / July 1 cycle each state fiscal year. Members owe no cost-sharing, so what’s on the fee schedule is what you collect.
Billing Notes
Initial ABA services start after you submit an “Intent to Initiate Treatment,” which authorizes 1,260 units over the first 180 calendar days. To keep services going past that, the BCBA has to submit an “Additional Units of Service Request” at least 14 calendar days before the current authorization runs out, along with the Diagnostic Evaluation, the initial Behavior Identification Assessment, and the current treatment plan. Renewal requests also need a current BIA and treatment plan (plus an annual clinical re-assessment for SED cases). Every additional block of units has to be authorized before you deliver the service — approved renewals run for another 180 days, up to 1,260 units.
Telehealth is reimbursable, but it’s not the default. The manual requires a separate “Telehealth Exception Request” specifically when you’re requesting service delivery via telehealth, so treat it as an exception you have to request, not a standing option.
One billing quirk to plan around: all BCaBA- and RBT-delivered services are billed under the supervising BCBA’s own NPI, and the BCBA holds full professional responsibility for that work. The unit of service is 15 minutes.
Common Questions
What does Montana Medicaid pay for CPT 97153?
Montana Medicaid pays $11.36 per 15 minutes for 97153 (direct treatment by a technician). That is about $45.44 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 Montana 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: Idaho · Wyoming · North Dakota · South Dakota