ABA Medicaid rates in Idaho look very different from the rest of the country: Idaho Medicaid does not publish a 97153 technician rate on file, and its one ranked ABA-type rate is caregiver training billed under T1027, at $47.96 an hour. That ranks 42nd of 43 states and sits 49.4% below the national median of $94.80. The rate is $11.99 per 15-minute unit with modifier TL, effective 2018-07-01.
For an ABA agency, Idaho is the clearest example on file of a state that does not reimburse autism services through the standard 97151 to 97158 code series. Understanding how Idaho classifies these services matters more than any single rate. Every rate below is compiled from official Idaho Medicaid publications and links to its source document on the Idaho Medicaid rates hub.
Idaho Medicaid ABA reimbursement: one published code
| Service | Code | Idaho | National median |
|---|---|---|---|
| Caregiver training | T1027 (TL) | $47.96 an hour, 42 of 43 | $94.80 |
| Technician therapy | 97153 | none on file | $63.44 |
| Analyst plan changes | 97155 | none on file | $101.04 |
| Analyst assessment | 97151 | none on file | $116.56 |
| Technician assessment support | 97152 | none on file | $77.04 |
| Technician-led group | 97154 | none on file | $29.96 |
Idaho also has no rate on file for analyst-led groups (97158), where the national median is $37.30.
Idaho is the only state on the national low list for caregiver training that bills under T1027 rather than 97156; only Louisiana, at $21.00, ranks below it. The national comparison uses T1027 because Idaho publishes no 97156 rate.
MA25-21: the transition to behavioral intervention
The most important recent change for Idaho providers is MA25-21, "Behavioral Modification and Consultation Transition to Behavioral Intervention," published 2025-10-31 and effective 2025-12-01.
The title describes a reclassification: services previously billed as behavioral modification and consultation are moving to a behavioral intervention service. For an agency working with children with autism or developmental disabilities, that means billing codes, service definitions changed on 2025-12-01. Claims for dates of service after that date need to follow the new structure. Agencies should read MA25-21 alongside the Idaho fee schedule to confirm which codes and rates now apply to their services.
Because the transition is recent, the T1027 rate on this page, effective 2018-07-01, reflects the older structure.
Labor costs and the T1027 margin
Idaho's wage data sits close to, or slightly above, national levels. The median wage for the closest comparable analyst occupation was $30.46 an hour in May 2025, against $28.53 nationally. For the technician proxy, Idaho's median was $22.86, against $22.08. Both are proxy occupations and understate pay for credentialed staff.
The economics on T1027 are stark. At the analyst proxy wage, wages take 90.3% of the $47.96 hourly rate, leaving $4.67 an hour after a loaded wage. That margin cannot realistically cover travel, scheduling, supervision or administration. An agency staffing caregiver training with a credentialed analyst at this rate will struggle to break even unless other, better-paid services carry the overhead.
This is the central planning point for Idaho: the rate that is published is not one an ABA practice can build a business model around. Agencies should identify which Idaho services, under the behavioral intervention structure, carry their clinical work, and model revenue from those rates instead.
What an ABA agency should confirm before billing Idaho
Because Idaho does not follow the usual code set, a short checklist helps:
- Which service your work falls under after MA25-21, and the code and unit attached to it.
- Whether technician hours are billable as a distinct service, since no Idaho rate for 97153 is on file.
- How family training is billed, given the T1027 rate of $47.96 an hour.
- Which program pays: fee-for-service, the behavioral health plan or a developmental disability program.
Coverage rules for Idaho ABA-type services
The coverage rules on file list 0 prior-authorization rules and no limit for T1027. No other ABA codes appear in Idaho's coverage rules, consistent with the absence of 97151 to 97158 rates. Authorization requirements for behavioral intervention under MA25-21 should be checked in the state's program guidance.
Programs and managed care in Idaho
Idaho's programs on file include Idaho Medicaid fee-for-service, administered by the Division of Medicaid; the Idaho Behavioral Health Plan, a statewide behavioral health prepaid plan; the Children's DD State Plan HCBS program for support and family-directed services; and the Adult DD State Plan HCBS program.
The state sheet records no managed-care rule specifically for ABA or behavioral health. Seven plans are on file; the Idaho managed-care page lists them and the rules for the service lines that are classified.
How Idaho compares with the ABA leaders
The contrast with the top states is sharp. On caregiver training, Rhode Island pays $219.88 under T1027, Hawaii $184.80 and Alaska $167.88, while Idaho pays $47.96. On technician therapy, where Idaho publishes no rate, Alaska pays $127.80, Georgia $123.64 and Iowa $114.36, and the national median is $63.44.
For a Mountain-region operator, Idaho requires a separate business model from neighboring states that pay on the 97151 to 97158 series. The national ABA rates hub shows which states use those codes, and our methodology explains how HCPCS-coded services such as T1027 are compared with CPT-coded rates.
Updated 2026-10-05