New Hampshire Medicaid ABA Reimbursement Rates (2026)
From official New Hampshire Medicaid sources. Updated July 2026.
These are the published New Hampshire 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.
New Hampshire ABA Fee Schedule
| Code | Service | Rate | Unit | Effective | Source |
|---|---|---|---|---|---|
| 97151 | Behavior identification assessment by phys/QHP (no tiering) Rate verified in 2026 NH Fee Schedule report; stored effective date 2024-07-01 corrected to pricing begin date 07/01/2023. SA (prior auth) required; max 32 units. | $16.43 | per 15 min | 2023-07-01 | source |
| 97151 (TM) | Behavior identification assessment, TM-modifier variant (no service authorization) State publishes a second 97151 row with modifier TM: same $16.43 rate, no SA required, max 8 units. | $16.43 | per 15 min | 2023-07-01 | source |
| 97153 | Adaptive behavior treatment by protocol, by technician (no tiering) Rate verified; stored effective date 2024-07-01 corrected to 07/01/2023. SA required; max 32 units. Per NH 25-0020 billable for 1:1 services only effective 9/1/2025 (group goes to 97154). | $17.79 | per 15 min | 2023-07-01 | source |
| 97153 (TM) | Adaptive behavior treatment by technician, TM-modifier variant (no service authorization) Second 97153 row with modifier TM: same $17.79 rate, no SA required, max 8 units. | $17.79 | per 15 min | 2023-07-01 | source |
| 97154 | Group adaptive behavior treatment by technician (priced per participant) New code added effective 09/01/2025 per public notice NH 25-0020. No SA; max 18 units. | $6.50 | per 15 min | 2025-09-01 | source |
| 97155 | Adaptive behavior treatment with protocol modification by phys/QHP Still listed as covered ($16.43, SA required, max 24 units, end date 12/31/9999) on the fee schedule as of 01-01-2026, even though notice NH 25-0020 proposed discontinuing coverage effective 9/1/2025. Monitor for removal. | $16.43 | per 15 min | 2023-07-01 | source |
| 97156 | Family adaptive behavior treatment guidance by phys/QHP SA required; max 32 units. | $16.43 | per 15 min | 2023-07-01 | source |
How New Hampshire Compares
| Code | New Hampshire | National median | Difference |
|---|---|---|---|
| 97151 | $16.43 | $29.14 | 44% below national median |
| 97153 | $17.79 | $15.00 | 19% above national median |
| 97155 | $16.43 | $24.18 | 32% below national median |
| 97156 | $16.43 | $22.50 | 27% below national median |
Market Context
New Hampshire has had an autism insurance mandate since 1994. About 87,666 children in New Hampshire are enrolled in Medicaid. Autism prevalence is 4.8% (2022 data). ProviderSpark lists 43 verified ABA provider locations in New Hampshire.
Getting Paneled with NH Medicaid
New Hampshire doesn’t brand its Medicaid program the way some states do. There’s no “TennCare” or “Medi-Cal” here, just NH Medicaid. Enrollment runs through the state’s MMIS portal:
- Start your application on the NH MMIS Health Enterprise Portal’s “Become a Provider” page, choosing the right provider type: billing group/individual, non-billing rendering/ORP, or trading partner.
- Review the Provider Enrollment Overview Guide before you apply. Most NH Medicaid members are in managed care, so you enroll with the state first and credential separately with each plan.
- Track your application under Provider > Enrollment > Application Status, or log in through the Provider Login page.
- Once approved, you’ll get an NH Medicaid ID for fee-for-service claims. You still need to separately credential and contract with each MCO you plan to bill.
- For enrollment or billing questions, call the NH Medicaid Provider Relations Call Center at 866-291-1674.
How New Hampshire Delivers ABA
New Hampshire runs a hybrid model. Some claims go through fee-for-service, but most members are covered through one of three managed care organizations: AmeriHealth Caritas New Hampshire, NH Healthy Families (Centene), and WellSense Health Plan (formerly Boston Medical Center HealthNet Plan). If you want to bill for the majority of NH Medicaid clients, plan on contracting with all three MCOs, not just enrolling with the state. Each MCO credentials separately, and the rate you actually collect depends on which plan your client is enrolled in, not just the state fee schedule.
Billing Notes
Prior authorization is required. NH Healthy Families’ payment policy states that ABA “must be billed under the qualified rendering provider and will continue to require prior authorization,” and a 2019 NH Medicaid bulletin confirms service authorizations are required for assessment (97151), direct treatment (97153), supervision (97155), and parent training (97156).
Watch CPT 97155 closely. In June 2025, NH Medicaid announced it would stop covering 97155 (supervision) effective July 1, 2025, and told providers to bill 97153 instead. Six weeks later, in August 2025, NH Medicaid formally retracted that change and confirmed 97155 “will continue to be a covered and reimbursable service.” CPT 97154 (group treatment) was added to the code set effective September 1, 2025.
Whether ABA delivered via telehealth is reimbursable under NH Medicaid or its MCOs isn’t confirmed in any document reviewed. Check directly with the plan before assuming it’s covered.
Common Questions
What does New Hampshire Medicaid pay for CPT 97153?
New Hampshire Medicaid pays $17.79 per 15 minutes for 97153 (direct treatment by a technician). That is about $71.16 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 New Hampshire 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: Massachusetts · Maine · Vermont