ABA Medicaid rates in North Dakota pull in two directions. For code 97153, one-on-one ABA delivered by a technician, North Dakota Medicaid pays $43.24 an hour, 38th of 42 states and 31.8% below the national median of $63.44. For analyst time on 97155 it pays $127.04 an hour, 13th of 41 states and 25.7% above the national median. The result is an unusually wide gap between what the state pays for technician time and analyst time.
All of North Dakota's ABA rates were refreshed on July 1, 2026, so the figures here are current for the 2026 budget year. They are compiled from official North Dakota Medicaid publications, and each rate links to its source document on the North Dakota Medicaid rates hub.
| Code | Service | ND per hour | Rank | vs national median |
|---|---|---|---|---|
| 97153 | One-on-one ABA by a technician | $43.24 | 38 of 42 | -31.8% |
| 97155 | Treatment with plan changes by an analyst | $127.04 | 13 of 41 | +25.7% |
| 97151 | Assessment by an analyst | $127.04 | 18 of 41 | +9.0% |
| 97156 | Parent and caregiver training | $117.92 | 12 of 43 | +24.4% |
| 97152 | Assessment support by a technician | $94.04 | 8 of 29 | +22.1% |
| 97154 | Group ABA led by a technician | $10.88 | 35 of 37 | -63.7% |
Every code is paid per 15-minute unit with no modifier. The analyst codes 97151 and 97155 share a single rate of $31.76 per unit, which simplifies billing: an hour of analyst time pays the same whether it is assessment or treatment with protocol changes.
North Dakota pays $10.81 per unit for 97153. That puts it in the bottom group nationally, alongside New York at $38.52 and Louisiana at $40.00, and far from Alaska at $127.80 or Georgia at $123.64.
What makes the technician rate hard in North Dakota is that local wages are not low. Federal data for May 2025 puts the median wage for the closest comparable technician occupation at $22.24 an hour in North Dakota, slightly above the national $22.08. That wage is 73.1% of the 97153 rate, and the margin after a loaded wage is $11.63 an hour. Supervision, travel, cancellations and administration all have to come out of that margin.
For an agency, the technician hour in North Dakota is close to a break-even line. Volume alone will not build a sustainable program; the analyst and assessment codes have to carry the overhead.
A margin of $11.63 leaves almost no room for unpaid time. A 30-minute drive to a client's home, a session cancelled at the door or an hour of documentation after the session can each consume the margin on several billed hours.
Agencies that make technician hours work in North Dakota tend to concentrate services. Clinic-based sessions, where children come to the provider and cancellations can be filled from a waitlist, keep technicians billing for most of their paid time. Where home-based services are necessary, clustering clients by area and scheduling sessions back to back reduces the unpaid gaps.
Retention matters as much as scheduling. With wages taking most of the rate, there is little room to compete for staff on pay, and each departure brings unbilled hiring and training time. Predictable schedules, good supervision and clear career paths toward analyst credentials do more to stabilize a technician workforce than small wage differences.
The analyst side of the schedule is where North Dakota is competitive. At $127.04 an hour, 97155 ranks 13th of 41 states, ahead of the national median of $101.04, though still below Vermont at $197.40, Alaska at $167.88 and South Dakota at $156.00.
The analyst assessment (97151) pays the same $127.04 an hour, 18th of 41 and 9.0% above the national median. Caregiver training (97156) pays $29.48 per unit, or $117.92 an hour, 12th of 43 states.
Technician assessment support
Technician assessment support (97152) pays $23.51 per unit, or $94.04 an hour, 8th of 29 states and 22.1% above the median. Notice that this is more than double the 97153 rate for the same technician's time. Agencies that involve technicians in structured assessment work, where clinically appropriate and authorized, earn far more for that time than for direct therapy.
The analyst proxy wage in North Dakota is $33.00 an hour, above the national $28.53. Even so, margins are healthy:
- 97155 and 97151: the wage is 36.9% of the $127.04 rate, leaving $80.14 an hour after a loaded wage.
- 97156 caregiver training: 39.8% of $117.92, leaving $71.02 an hour.
- 97152 technician assessment support: 33.6% of $94.04, leaving $62.43 an hour.
These margins point toward a supervision-rich model: more analyst hours per case, regular caregiver training sessions and thorough assessments, rather than a model built on maximum technician volume.
That is also a model many clinicians favor. Frequent analyst involvement keeps treatment plans current, and regular caregiver training helps families carry skills into daily life. In North Dakota, the rate structure and good clinical practice point in the same direction. The constraint is BCBA supply: recruiting and keeping analysts is the main limit on growth, and the analyst margin gives agencies room to pay competitively for them.
Technician-led group ABA (97154) pays $2.72 per unit, or $10.88 an hour. North Dakota appears on the national list of lowest-paying states for 97154, with only Missouri at $8.20 and Texas at $6.52 below it. Against the national median of $29.96, it is 63.7% lower. North Dakota is not ranked on analyst-led groups (97158).
Group sessions in North Dakota therefore make sense only for clinical reasons, not as a way to stretch technician capacity. Even a large group, billing the per-child rate for each participant, earns little relative to the staff time it takes.
The North Dakota schedule attaches one prior authorization rule to each ABA code from 97151 through 97156, and none has a published unit limit. Agencies should still confirm hour caps and documentation requirements in the provider manual before building a treatment plan.
A uniform rule across codes allows one authorization workflow for every service: confirm the rule at intake, record authorized units and dates, and request renewals before expiry. Without published unit limits, the authorization itself is the control on billable hours, so delivering beyond it, or after it lapses, is the costliest error to avoid.
ABA in North Dakota is billed through North Dakota Medicaid on a fee-for-service basis, so the published rate is the payment. Five plans and program arrangements are on file in the state, including primary care case management, but none sets its own ABA rates. For how they are organized, see the North Dakota managed care page.
For an agency, fee-for-service means one rate per code statewide and no plan contracts to negotiate. It also means the only route to a higher technician rate is a change to the state schedule. North Dakota updates its fee schedules on a regular cycle: the Public Notice for Medicaid State Plan Changes for July 1, 2026 was recorded with a 2.0% change, and the notice for January 1, 2026 with 3.2%. Agencies should check each new edition for changes to ABA codes.
North Dakota's profile, low on technician time and above median on analyst time, is worth comparing with its neighbors. Its $10.81 technician unit is the lowest in the region, below Kansas ($16.25), Missouri ($17.73), Nebraska ($18.70), Minnesota ($20.17), South Dakota ($21.73) and Iowa ($28.59). South Dakota is also among the top five states on 97155.
At the extremes, Alaska and Georgia lead on technician pay, while West Virginia shows a technician figure of $10.00 an hour under code H2014. For a regional operator, North Dakota is the market where analyst capacity, not technician volume, decides whether a program works.
Start with the analyst share of the hours mix, since in North Dakota it carries most of the margin. Model analyst treatment, assessment, caregiver training and technician assessment support as separate lines, then add technician hours at the 97153 rate.
Then model delivered hours rather than authorized hours, with realistic travel and cancellation assumptions for technicians. Test the budget at a lower delivery rate as well: because the technician margin is so thin, a small drop in delivered hours can turn a modest surplus into a loss.
For wages, use what credentialed staff actually cost locally rather than the federal proxies, which are floors. And plan for growth around analyst hiring. Each additional BCBA adds analyst treatment, assessment and caregiver-training capacity at the codes that carry the margin, and also supports the supervision that additional technician hours require. The national ABA rates hub compares every state, and the North Dakota hub covers all 19,715 current North Dakota Medicaid rates.
Rates on this page are compiled from official North Dakota Medicaid publications, including the fee schedules for dates of service from July 1, 2026. Each rate in the full dataset links to its source document and effective date. Our methodology explains how 15-minute units are converted and ranked. The full North Dakota dataset carries history back to 2023, so each earlier edition of a rate can be compared with the current one and priced on its own date of service. Pricing covers access.