97155 Medicaid reimbursement rates by state
ABA therapy led by the analyst (plan adjusted in session). 19 state Medicaid programs publish a fee-for-service rate for 97155 at the analyst level. Rates run from $14.09 in Washington to $40.14 in Georgia, with a median of $25.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 19
- Median rate
- $25.10units vary by state
- Highest
- $40.14Georgia
- Medicare (non-facility)
- —not on the physician fee schedule
97155 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| GeorgiaBehavior analyst (BCBA / licensed behavior analyst) · Georgia Medicaid (fee-for-service) | $40.14since 2025-07-01 | 15 min | $160.56 | Plans negotiate; applies out of network | — | Georgia Medicaid Autism Spectrum Disorde |
| VirginiaBehavior analyst (BCBA / licensed behavior analyst) · Virginia Medicaid (fee-for-service, DMAS) | $39.40since 2021-12-01 | 15 min | $157.60 | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| MarylandBehavior analyst (BCBA / licensed behavior analyst) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $38.34since 2024-07-01 | 15 min | $153.36 | Paid by the state, outside plans | — | ABA Fee Schedule FY25 |
| North CarolinaBehavior analyst (BCBA / licensed behavior analyst) · North Carolina Medicaid Direct (fee-for-service) | $32.22since 2025-10-01 | 15 min | $128.88 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'LCSW LCMHC LMF |
| MassachusettsBehavior analyst (BCBA / licensed behavior analyst) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $30.73since 2024-10-01 | 15 min | $122.92 | Plans must pay at least this | — | Rates for Applied Behavior Analysis (eff |
| ArizonaBehavior analyst (BCBA / licensed behavior analyst) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $27.72since 2026-10-01 | 15 min | $110.88 | Plans negotiate; applies out of network | — | AHCCCS FFS Program Capped Fee Schedule: |
| IndianaBehavior analyst (BCBA / licensed behavior analyst) · Indiana Medicaid (fee-for-service) | $25.97since 2026-04-01 | 15 min | $103.88 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ColoradoBehavior analyst (BCBA / licensed behavior analyst) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $25.80since 2025-10-01 | 15 min | $103.20 | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2025 - 2026 Fe |
| MissouriBehavior analyst (BCBA / licensed behavior analyst) · Missouri MO HealthNet (fee-for-service) | $25.26since 2022-07-01 | 15 min | $101.04 | Paid by the state, outside plans | — | MO HealthNet fee schedule: Applied Behav |
| TexasBehavior analyst (BCBA / licensed behavior analyst) · Texas Medicaid (fee-for-service, TMHP) | $25.10since 2025-09-01 | 15 min | $100.40 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Autis |
| WisconsinBehavior analyst (BCBA / licensed behavior analyst) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $22.93since 2023-02-01 | 15 min | $91.72 | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Behavior |
| NebraskaBehavior analyst (BCBA / licensed behavior analyst) · Nebraska Medicaid (fee-for-service) | $22.72since 2026-07-01 | 15 min | $90.88 | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| PennsylvaniaBehavior analyst (BCBA / licensed behavior analyst) · Pennsylvania Medical Assistance (fee-for-service) | $22.09since 2021-09-30 | 15 min | $88.36 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| New JerseyBehavior analyst (BCBA / licensed behavior analyst) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $21.25since 2025-01-01 | 15 min | $85.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IllinoisBehavior analyst (BCBA / licensed behavior analyst) · Illinois Medicaid (HFS fee-for-service) | $20.39since 2022-01-15 | 1/4 hr | — | Plans negotiate; applies out of network | — | HFS Adaptive Behavior Support (ABS) Serv |
| MinnesotaBehavior analyst (BCBA / licensed behavior analyst) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $20.17since 2024-01-01 | 15 min | $80.68 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New YorkBehavior analyst (BCBA / licensed behavior analyst) · New York Medicaid (fee-for-service) | $19.26since 2022-04-01 | 15 min | $77.04 | Not classified | — | eMedNY NYS Medicaid Applied Behavior Ana |
| FloridaBehavior analyst (BCBA / licensed behavior analyst) · Florida Medicaid (fee-for-service) | $19.17since 2026-01-01 | 15 min | $76.68 | Plans negotiate; applies out of network | — | Behavior Analysis Fee Schedule (Updated |
| WashingtonBehavior analyst (BCBA / licensed behavior analyst) · Washington Apple Health (Medicaid) fee-for-service | $14.09since 2026-01-01 | 15 minute units | $56.36 | Plans must pay at least this | — | HCA ABA fee schedule (aba-20260101.xlsx) |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 97155?
It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $25.10. Georgia pays the most ($40.14 per 15 min) and Washington the least ($14.09 per 15 minute units).
Which state pays the highest Medicaid rate for 97155?
Georgia, at $40.14 per 15 min ($160.56 per hour), effective 2025-07-01.
Do managed-care plans pay the same rate for 97155?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.
Related ABA / autism services codes
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Track 97155 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.