Texas raised the Medicaid rate it pays for the core of ABA therapy. It’s a strong example of a state investing in access to care, and a reminder of what a well-run agency can do when reimbursement moves in the right direction.
What changed in Texas ABA reimbursement
The Texas Legislature wrote the new rate into the state budget (Rider 30), directing the Health and Human Services Commission to raise the Medicaid reimbursement rate for certain ABA services to $14.50 per unit. HHSC presented the change at a public rate hearing in July 2025,1 and TMHP, which administers Texas Medicaid claims, implemented the new rates for dates of service on or after September 1, 2025.2
The code that rose is CPT 97153, the one-to-one treatment most often delivered by an RBT. It went from $13.00 to $14.50 per 15-minute unit,1 or $58 an hour. That’s an increase of about 11.5% on the service that makes up a large share of a typical treatment week.
Why 97153 matters most
For many agencies, 97153 is the biggest line of revenue, because it covers the hours an RBT spends in direct treatment with a child. A $1.50 increase per unit sounds small, but it’s $6 for every hour of therapy, and across a full month of treatment hours it adds up to real room for better pay and more capacity.
Texas ABA Medicaid rates at a glance
| Code | Service | Rate |
|---|---|---|
| 97153 | Treatment by protocol (RBT) | $14.50 |
| 97155 (HO) | Protocol modification, BCBA/LBA | $25.10 |
| 97155 (HN) | Protocol modification, BCaBA | $20.08 |
| 97151 (HO) | Behavior identification assessment | $27.56 |
Rates effective September 1, 2025, as listed in HHSC’s rate notice (HO: licensed behavior analyst; HN: licensed assistant behavior analyst). Managed care plans pay under their own contracts, so check the current TMHP fee schedule and your contracts before you budget.
Who Texas Medicaid ABA covers
Texas Medicaid’s autism services benefit, including ABA evaluation and treatment, began on February 1, 2022, for Texas Medicaid recipients age 20 and younger, through Texas Health Steps-Comprehensive Care Program.3 With 97153 now at $14.50, the state’s rates reward both clinical assessment and the direct treatment hours that make up much of a child’s week.
Texas BCBA demand
Texas is one of the busiest ABA markets in the country. Job postings asking for BCBA certification in Texas rose 32% in 2025, to 7,792, the third most of any state.4
It’s not the first time advocacy has paid off
New Jersey offers an earlier example. In February 2022, after work by Autism New Jersey with the state’s Medicaid agency, the behavior technician rate under NJ FamilyCare rose from $11.20 to $15 per 15-minute unit.5 In both states, providers, families and advocates made a clear case for the value of the care, and the state responded.
What a rate increase makes possible
- Better RBT pay, which helps with hiring and keeping the people who deliver most of the hours.
- More capacity, so families on a waitlist can start sooner.
- Room to invest in supervision, training and the systems that keep quality high.
- A stronger base for growth, whether that’s a new clinic or a new region.
The agencies that benefit most are the ones that know their numbers. When you can see your cost per hour and your utilization clearly, you can decide exactly where a higher rate should go.
What Texas ABA owners can do now
- Check your managed care contracts to confirm the new 97153 rate is being paid on every claim since September 1, 2025.
- Revisit RBT pay and schedules, since 97153 funds most technician wages.
- Look at capacity. If families are waiting, the higher rate may support another hire or a new clinic location.
- Watch utilization. A higher rate pays off most when authorized hours are actually delivered and billed.
How we help
That’s the work we do with small and mid-size ABA agencies: real-time visibility into cost per hour and utilization, collections that keep cash flowing, and a plan for putting better reimbursement to work, in pay, capacity or a new clinic.
Frequently asked questions
What is the Texas Medicaid rate for 97153?
$14.50 per 15-minute unit ($58 an hour), effective September 1, 2025, up from $13.00.
What does Texas Medicaid pay for 97155?
HHSC’s rate notice lists $25.10 per unit for 97155 delivered at the BCBA/LBA (HO) level and $20.08 at the BCaBA (HN) level.
When did the Texas ABA rate increase take effect?
For dates of service on or after September 1, 2025, under Rider 30 of the state budget.
Sources
Figures as published on the dates shown. Rates and pay change; check the current fee schedule or source before relying on a number.
- Texas Health and Human Services Commission, Provider Finance Department, Notice of proposed adjustments to fees, rates, or charges, Applied Behavior Analysis Services, Attachment A(2) (public rate hearing July 22, 2025).
- Texas Medicaid & Healthcare Partnership (TMHP), Reimbursement rate updates for procedure codes presented at the July 22, 2025, public rate hearing (August 21, 2025).
- Texas Medicaid & Healthcare Partnership (TMHP), HHSC release of autism services benefits effective February 1, 2022 (July 30, 2021).
- Behavior Analyst Certification Board, US employment demand for behavior analysts: 2010–2025 (Lightcast job-posting data) (updated January 2026).
- Autism New Jersey, Autism New Jersey’s advocacy leads to Medicaid rate increase for ABA services (February 1, 2022).