Overview
Applied Behavior Analysis (ABA) therapy uses a specific set of CPT and HCPCS procedure codes that were formally established in 2019. Understanding these codes is essential for accurate billing and reimbursement. This guide covers all ABA-specific codes with their official descriptions and billing requirements.
Assessment Codes
97151 — Behavior Identification Assessment
Used for the initial assessment and re-assessments conducted by a BCBA or BCaBA. Billed in 15-minute units. Includes direct observation, data analysis, and report writing.
- Minimum unit: 1 unit (15 minutes)
- Rendering provider: BCBA or BCaBA only
- Supervision not required: BCBAs render independently
- Place of service: Any
97152 — Behavior Identification-Supporting Assessment
Supporting assessment services, such as data collection observation, conducted by a technician under a BCBA's supervision.
- Minimum unit: 1 unit (15 minutes)
- Rendering provider: RBT, paraprofessional, or technician under BCBA
- Must be ordered by: BCBA or physician
Treatment Codes
97153 — Adaptive Behavior Treatment by Protocol
Direct ABA therapy provided by a technician (RBT) implementing a behavior intervention plan developed by a BCBA. This is the most frequently billed ABA code.
- Minimum unit: 1 unit (15 minutes)
- Rendering provider: RBT or paraprofessional under BCBA supervision
- Supervision requirement: BCBA must be accessible and provide required oversight
97154 — Group Adaptive Behavior Treatment by Protocol
ABA group treatment, with 2–8 patients receiving services simultaneously from a single provider.
- Group size: 2–8 patients
- Billing: Billed per patient, not per group
- Rendering provider: RBT or technician
97155 — Adaptive Behavior Treatment with Protocol Modification
BCBA-delivered direct treatment that involves modifying the behavior intervention plan in real time. Higher complexity and reimbursement rate than 97153.
- Rendering provider: BCBA or BCaBA only
- Documentation required: Notes showing protocol modification occurred
97156 — Family Adaptive Behavior Treatment Guidance
Training and guidance provided to parents/caregivers by a BCBA. Also referred to as "caregiver training."
- Rendering provider: BCBA
- Who is present: Caregiver, not the patient
- Common location: Home, clinic, or school
97157 — Multiple-Family Group Adaptive Behavior Treatment Guidance
Caregiver training provided to multiple families simultaneously (2–8 families).
97158 — Group Adaptive Behavior Treatment with Protocol Modification
BCBA-delivered group treatment with protocol modification for 2–8 patients.
HCPCS Codes
H2019 — Therapeutic Behavioral Services
Used by some state Medicaid programs as an alternative to CPT 97153. Often billed per 15-minute unit. Always verify with your state Medicaid plan whether they prefer H2019 or 97153.
Key Billing Rules
- All ABA codes are billed in 15-minute increments unless otherwise specified
- Most payers require a behavior identification assessment (97151) before authorizing treatment codes
- Group codes (97154, 97157, 97158) require at least 2 patients; if only 1 patient is present, bill the individual equivalent
- Always check payer-specific modifier requirements — many require HO, HN, or HM