ABA Medicaid Rates: Pennsylvania

Medical Assistance fee-for-service — Intensive Behavioral Health Services, Applied Behavior Analysis (Provider Type 11, Specialty 592), Pennsylvania Department of Human Services

Effective 2020-01-17 LAST CHECKED 2026-08

Code	Service	Rate	Unit
97151	Behavior identification assessment — behavior consultation, ABA · No prior authorization.	$22.09	15 min
97151 U7	Behavior identification assessment — behavior analytic level · Pricing modifier U7 marks the behavior analytic level.	$24.73	15 min
97152	Behavior identification-supporting assessment — behavioral health technician, ABA · Prior authorization required.	$12.73	15 min
97152 U8	Behavior identification-supporting assessment — assistant behavior consultation, ABA · Pricing modifier U8.	$15.76	15 min
97153	Adaptive behavior treatment by protocol — behavioral health technician, ABA · Prior authorization required. Printed limit of 1 to 32 units per day.	$12.73	15 min
97153 U8	Adaptive behavior treatment by protocol — assistant behavior consultation, ABA · Pricing modifier U8. Same daily limit.	$15.76	15 min
97154 U6	Group adaptive behavior treatment by protocol — up to 3 group members · Group size is set by the pricing modifier, and the modifier changes the rate.	$16.63	15 min
97154 U5	Group adaptive behavior treatment by protocol — 4 to 6 group members	$8.15	15 min
97154	Group adaptive behavior treatment by protocol — 7 to 12 group members	$5.13	15 min
97155	Adaptive behavior treatment with protocol modification — behavior consultation, ABA · No prior authorization. Printed limit of 1 to 32 units per day.	$22.09	15 min
97155 U7	Adaptive behavior treatment with protocol modification — behavior analytic level	$24.73	15 min
97156	Family adaptive behavior treatment guidance — behavior consultation, ABA · No prior authorization.	$22.09	15 min
97156 U7	Family adaptive behavior treatment guidance — behavior analytic level	$24.73	15 min
97158 U6	Group adaptive behavior treatment with protocol modification — up to 3 group members	$16.63	15 min
97158 U5	Group adaptive behavior treatment with protocol modification — 4 to 6 group members	$8.15	15 min
97158	Group adaptive behavior treatment with protocol modification — 7 to 12 group members	$5.13	15 min

Read before using these numbers

Pennsylvania prices ABA by pricing modifier, and the modifier changes the rate. Quoting a bare CPT code here will misstate what is paid. U7 marks the behavior analytic (BCBA) level, U8 the assistant behavior consultation level, and U6 and U5 set group size on 97154 and 97158.
97157, 0362T and 0373T are not on the Medical Assistance fee schedule. A search of the department's own Outpatient Fee Schedule tool across all provider types returns no record for any of the three.
Pennsylvania delivers ABA as a sub-category of Intensive Behavioral Health Services under 55 Pa. Code Chapters 1155 and 5240. ABA is billed by Provider Type 11 with Specialty 592. The Individual (590) and Group (591) IBHS specialties bill H-codes instead — those are separate, non-ABA services and are not on this page.
These are fee-for-service rates. The bulletin says so directly: it applies to providers in the fee-for-service delivery system, and providers in managed care 'should address any coding or billing questions to the appropriate behavioral health managed care organization.' Most Pennsylvania Medicaid children receive IBHS through county Behavioral Health HealthChoices organizations, whose negotiated rates are not public.
These rates have not changed since January 2020. The department's live Max Fee History shows a begin date of 17 January 2020 and an open-ended end date for every code. Later begin dates on individual rows reflect the addition of new places of service, not rate changes — the dollar amount is identical on each.
The complete downloadable fee schedule files require a PROMISe login. The public search tool linked above returns the same data and is what a reader can check.
Rows carrying modifier FQ (audio-only telehealth) render inconsistently in the department's online tool, showing as 'Please See Details' or 0.00 in list views while the per-row detail page prices them identically to the base rate. Those rows are not published here.
Re-verified 12 August 2026 by querying the department's live Outpatient Fee Schedule tool (PT 11 / specialty 592): base and modifier rates for 97151 and 97153 match this page exactly; no newer MA bulletin revising ABA rates was found.

Official sources

OMHSAS Bulletin OMHSAS-20-01, Procedure Codes for Intensive Behavioral Health Services Agencies — Pennsylvania Department of Human Services, Office of Mental Health and Substance Abuse Services, issued 31 January 2020, effective 17 January 2020 Medical Assistance Program Fee Schedule for Intensive Behavioral Health Services: Addition of Procedure Codes; Prior Authorization Requirements, 50 Pa.B. 741, 1 February 2020 Pennsylvania DHS Medical Assistance Outpatient Fee Schedule search — the live tool where these rates can be queried per code

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:

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