Horizon BCBS NJ reimbursement rates in Pennsylvania
For 97153 (one-on-one ABA therapy by a technician), the median of Horizon BCBS NJ's published Pennsylvania rates is $29.41 per 15 min (49 rates, 192 providers). That is 131% above Pennsylvania Medicaid's fee-for-service rate of $12.73.
- Codes with a median
- 78
- 97153 median
- $29.41per 15 min
- Files
- September 2026
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Horizon BCBS NJ vs Pennsylvania Medicaid
Across 49 published rates from 192 providers, Horizon BCBS NJ pays a median of $29.41 per 15 min for 97155 (ABA therapy led by the analyst (plan adjusted in session)) in Pennsylvania. That is 33% above Pennsylvania Medicaid's fee-for-service rate of $22.09. Horizon BCBS NJ publishes Pennsylvania rates for 78 of the codes we track, across commercial, marketplace (aca) plans. Figures are from the September 2026 files.
| Code | Horizon BCBS NJ median | Per hour | Pennsylvania Medicaid | TRICARE | Rates (n) |
|---|---|---|---|---|---|
| 97153One-on-one ABA therapy by a technician | $29.41per 15 min | $117.64 | $12.73131% above | — | 49192 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $29.41per 15 min | $117.64 | $22.0933% above | — | 49192 providers |
All 78 Horizon BCBS NJ codes with a median in Pennsylvania
Frequently asked questions
What does Horizon BCBS NJ pay for 97153 in Pennsylvania?
The median of Horizon BCBS NJ's published Pennsylvania rates for 97153 is $29.41 per 15 min ($117.64 per hour), from 49 rates and 192 providers in the September 2026 files.
Does Horizon BCBS NJ pay more than Pennsylvania Medicaid for 97153?
Horizon BCBS NJ's median is 131% above the Medicaid fee-for-service rate of $12.73 per 15 min.
What does Horizon BCBS NJ pay for 97155 in Pennsylvania?
The median of Horizon BCBS NJ's published Pennsylvania rates for 97155 is $29.41 per 15 min ($117.64 per hour), from 49 rates and 192 providers in the September 2026 files.
Does Horizon BCBS NJ pay more than Pennsylvania Medicaid for 97155?
Horizon BCBS NJ's median is 33% above the Medicaid fee-for-service rate of $22.09 per 15 min.
How many codes does Horizon BCBS NJ publish rates for in Pennsylvania?
78 of the behavioral health, ABA, therapy, home health and other codes we track have a Horizon BCBS NJ median in Pennsylvania. The full list, with ranges and modifier tiers, is in the workspace.