ABA Medicaid reimbursement rates by state (2026): 97153, 97155 and 97151

There is no single national Medicaid rate for ABA therapy. Each state sets its own, and the difference from one state to the next can be large. Below are current ABA Medicaid reimbursement rates for six states, taken directly from each state’s published fee schedule, with notes on recent increases and how to read a schedule.

The ABA CPT codes that drive revenue

• 97153, adaptive behavior treatment by protocol. The one-to-one treatment usually delivered by an RBT. It’s the highest-volume code for many agencies.
• 97155, treatment with protocol modification. BCBA time spent directing treatment and adjusting the protocol.
• 97151, behavior identification assessment. The BCBA’s assessment and treatment planning.
• 97156, family adaptive behavior treatment guidance. Caregiver training led by the BCBA.

All four are billed in 15-minute units, so one hour equals four units.

ABA Medicaid rates by state (per 15-minute unit)

Rates as published on the dates shown, per 15-minute unit, fee-for-service. Maryland’s 97153 rate shown is for RBTs and behavior technicians; it pays more when a BCaBA or BCBA delivers the service. “HO” is the master’s-level (BCBA) modifier. Always check your state’s current fee schedule before you budget.

In hourly terms, 97153 works out to about $76.68 in Maryland, $71.64 in Arizona, $69.40 in Oklahoma, $60 in New Jersey, $58 in Texas and $49.04 in Florida.

What a rate means in practice

Because 97153 is billed in 15-minute units, small differences add up fast. Take one client authorized for 20 hours a week of 97153, which is 80 units. At Texas’s $14.50 rate that’s $1,160 a week; at Oklahoma’s $17.35 it’s $1,388. Across a caseload of dozens of clients and a full year, the rate on this one code shapes what an agency can pay its RBTs, how much supervision it can afford, and how fast it can grow.

That’s also why two other numbers matter as much as the rate itself: how many authorized hours you actually deliver, and how much of what you bill you actually collect. A strong rate with weak utilization can earn less than a modest rate run well.

Recent ABA rate increases worth knowing

• Texas (2025). The Legislature directed a higher Medicaid rate for ABA, and 97153 rose from $13.00 to $14.50 per unit, effective September 1, 2025, an increase of about 11.5%.⁷⁵
• New Jersey. After advocacy with the state, the NJ FamilyCare behavior technician rate rose from $11.20 to $15 per 15-minute unit in February 2022,⁸ and $15.00 is still the 97153 rate on the 2026 schedule.⁴
• Arizona. AHCCCS pays a higher 97153 rate when therapy is delivered in the home ($19.96 versus $17.91), recognizing the extra cost of in-home care.²

Who pays for ABA

For ABA agencies, the major payers are Medicaid, which covers ABA for children and young adults under 21 through the EPSDT benefit (Maryland’s program is one example),¹ and commercial insurance.

How to read a Medicaid fee schedule

• Check the modifiers. Many states pay different rates by credential (for example HM, HN, HO and HP), as Arizona’s schedule shows.²
• Check the setting. Some states pay differently for home and clinic.
• Check the effective date. Rates can change mid-year, so confirm you’re using the current schedule.
• Check your managed care contracts. In many states, Medicaid managed care plans contract their own rates, so the fee-for-service schedule is a benchmark rather than a guarantee.

Medicaid rates vs. commercial rates

Commercial insurers negotiate their own ABA rates with each agency, so the same code can pay very differently from one contract to the next. Most agencies serve both payer types, so knowing your blended rate across Medicaid and commercial plans is the clearest picture of your revenue.

How we help

Reimbursement is where the finance work starts. We help small and mid-size ABA agencies understand their real collected rate per hour by payer, tighten billing and collections, and decide where new clinics or new states make sense. That turns a fee schedule into a growth plan.

Sources

Figures as published on the dates shown. Rates and pay change; check the current fee schedule or source before relying on a number.

1. Maryland Department of Health, ABA Provider Manual, including the ABA fee schedule (fee schedule effective February 1, 2026).
2. Arizona Health Care Cost Containment System (AHCCCS), Final Applied Behavior Analysis fee schedule, FFY26 (effective October 1, 2025).
3. Oklahoma Health Care Authority, SoonerCare (Title XIX) provider fee schedule (effective April 1, 2026).
4. New Jersey Medicaid (NJMMIS), CPT/HCPCS codes fee schedule, 2026 (2026 edition).
5. Texas Medicaid & Healthcare Partnership (TMHP), Reimbursement rate updates for procedure codes presented at the July 22, 2025, public rate hearing (August 21, 2025; effective for dates of service on or after September 1, 2025).
6. Florida Agency for Health Care Administration, 2026 Behavior Analysis fee schedule (2026 schedule).
7. Texas Health and Human Services Commission, Notice of proposed adjustments to fees, rates, or charges (Applied Behavior Analysis), effective September 1, 2025 (2025).
8. Autism New Jersey, Autism New Jersey’s advocacy leads to Medicaid rate increase for ABA services (February 1, 2022).