97156 Medicaid reimbursement rates by state
ABA parent or caregiver training by the analyst. 18 state Medicaid programs publish a fee-for-service rate for 97156 at the analyst level. Rates run from $17.52 in Georgia to $39.40 in Virginia, with a median of $23.36.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 18
- Median rate
- $23.36units vary by state
- Highest
- $39.40Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
97156 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 |
|---|---|---|---|---|---|---|
| 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 |
| 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 |
| WisconsinBehavior analyst (BCBA / licensed behavior analyst) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $28.03since 2023-02-01 | 15 min | $112.12 | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Behavior |
| IndianaBehavior analyst (BCBA / licensed behavior analyst) · Indiana Medicaid (fee-for-service) | $26.54since 2026-04-01 | 15 min | $106.16 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaBehavior analyst (BCBA / licensed behavior analyst) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $26.53since 2026-10-01 | 15 min | $106.12 | Plans negotiate; applies out of network | — | AHCCCS FFS Program Capped Fee Schedule: |
| NebraskaBehavior analyst (BCBA / licensed behavior analyst) · Nebraska Medicaid (fee-for-service) | $26.06since 2026-07-01 | 15 min | $104.24 | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| 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 |
| New JerseyBehavior analyst (BCBA / licensed behavior analyst) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $25.00since 2025-01-01 | 15 min | $100.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaBehavior analyst (BCBA / licensed behavior analyst) · North Carolina Medicaid Direct (fee-for-service) | $23.70since 2025-10-01 | 15 min | $94.80 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'LCSW LCMHC LMF |
| TexasBehavior analyst (BCBA / licensed behavior analyst) · Texas Medicaid (fee-for-service, TMHP) | $23.01since 2025-09-01 | 15 min | $92.04 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Autis |
| 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 ( |
| 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) | $20.91since 2024-07-01 | 15 min | $83.64 | Paid by the state, outside plans | — | ABA Fee Schedule FY25 |
| 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) | $19.05since 2026-01-01 | 15 min | $76.20 | Plans negotiate; applies out of network | — | Behavior Analysis Fee Schedule (Updated |
| WashingtonBehavior analyst (BCBA / licensed behavior analyst) · Washington Apple Health (Medicaid) fee-for-service | $18.32since 2026-01-01 | 15 minute units | $73.28 | Plans must pay at least this | — | HCA ABA fee schedule (aba-20260101.xlsx) |
| GeorgiaBehavior analyst (BCBA / licensed behavior analyst) · Georgia Medicaid (fee-for-service) | $17.52since 2025-07-01 | 15 min | $70.08 | Plans negotiate; applies out of network | — | Georgia Medicaid Autism Spectrum Disorde |
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 97156?
It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $23.36. Virginia pays the most ($39.40 per 15 min) and Georgia the least ($17.52 per 15 min).
Which state pays the highest Medicaid rate for 97156?
Virginia, at $39.40 per 15 min ($157.60 per hour), effective 2021-12-01.
Do managed-care plans pay the same rate for 97156?
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
97151Behavior assessment and treatment plan by the analyst · 19 states97153One-on-one ABA therapy by a technician · 19 states97154Group ABA therapy by a technician · 19 states97155ABA therapy led by the analyst (plan adjusted in session) · 19 states97158Group ABA therapy led by the analyst · 16 states97152Behavior assessment help from one technician · 14 states97157ABA parent or caregiver training for several families · 13 states0373TABA therapy with two or more technicians on site · 11 states0362TBehavior assessment help from two or more technicians · 9 statesT1027Family training and counseling for child development · 8 states
Track 97156 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.