ABA Medicaid Rates: New Jersey

NJ FamilyCare fee-for-service — Applied Behavior Analysis, New Jersey Division of Medical Assistance and Health Services (DMAHS)

Effective 2026-07-01 LAST CHECKED 2026-08

Code	Service	Rate	Unit
97151	Behavior identification assessment by physician or other qualified health professional · Suggested limit 32 units. Allowable specialties BCBA and BCBA-D per the 2020 newsletter.	$25.00	15 min
97152	Behavior identification supporting assessment by one technician · Suggested limit 8 units. RBT or BCaBA.	$11.20	15 min
97153	Adaptive behavior treatment by protocol, administered by a technician · Suggested limit 32 units. RBT or BCaBA. Increased from the $11.20 printed in the April 2020 newsletter; $15.00 is what the current schedule prints.	$15.00	15 min
97154	Group adaptive behavior treatment by protocol, administered by a technician · Suggested limit 12 units.	$4.80	15 min
97155	Adaptive behavior treatment with protocol modification by a qualified health professional · Suggested limit 24 units. BCBA or BCBA-D.	$21.25	15 min
97156	Family adaptive behavior treatment guidance · Suggested limit 16 units.	$25.00	15 min
97157	Multiple-family group adaptive behavior treatment guidance · Suggested limit 16 units.	$12.40	15 min
97158	Group adaptive behavior treatment with protocol modification · Suggested limit 16 units.	$5.60	15 min
0362T	Behavior identification supporting assessment, two or more technicians, destructive behavior, customized environment · Suggested limit 8 units. Requires a BCBA-D or BCBA with two or more RBTs or BCaBAs.	$25.00	15 min
0373T	Adaptive behavior treatment with protocol modification, two or more technicians, destructive behavior, customized environment · Suggested limit 32 units.	$16.40	15 min

Read before using these numbers

Two disclaimers are printed on the face of the schedule and both matter: 'THIS FILE IS FOR INFORMATIONAL PURPOSES ONLY' and 'Rates are proposed until CMS approval'. The header also reads '(Reflects 2025 Rates)', so the July 2026 file still carries the 2025 dollar values for these codes.
The ABA rows are priced only in the two children's columns. Both adult columns — FEE-SPECIALIST and FEE-NON-SPECIALIST — read 'NA' for every ABA code, consistent with ABA being an under-21 EPSDT benefit in New Jersey.
These are fee-for-service rates only. The 2020 newsletter says so explicitly: 'These rates are for the NJ FamilyCare Fee-for-Service only. These rates are not required to be utilized by NJ FamilyCare managed care plans.' Most New Jersey ABA volume is paid by managed care organizations at rates that are not public.
The fee schedule prints no unit column. The 15-minute unit comes from DMAHS Medicaid Newsletter Vol. 30 No. 06, which states 'ABA services shall be provided in 15 minute units' and prints '15 minutes' against all ten codes. Newsletter Vol. 36 No. 04 (April 2026) still directs providers to that 2020 newsletter for ABA coverage, so it remains the operative policy document.
The 2020 newsletter's dollar figures are now partly stale. It prints $11.20 for 97153 where the current schedule prints $15.00; the other nine codes match. The increase corresponds to a February 2022 DMAHS public notice on adaptive behavior treatment rates whose PDF we could not retrieve, so the $15.00 figure rests on the current fee schedule alone.
Supersession checked: the CY2026 quarterly schedules and the NJMMIS monthly procedure-code rate-change files for October 2025 through June 2026 contain no changes to any of the ten ABA codes.

Official sources

Medicaid Fee for Services: Update July 1, 2026 (Reflects 2025 Rates) — CPT/HCPCS/CDT fee-for-service fee schedule, New Jersey Division of Medical Assistance and Health Services, published on NJMMIS Provision of ABA services — DMAHS Medicaid Newsletter Volume 30, No. 06, April 2020, the document that states the 15-minute unit and the per-code suggested limits

Bill from the source, cite us for the map. If this page disagrees with the current official schedule, the schedule wins — and we want to know:

Report a change