ABA Medicaid Rates: Utah

Utah Medicaid — Applied Behavior Analysis under Autism Spectrum Disorder Services, Utah Department of Health and Human Services

Effective 2026-07-01 LAST CHECKED 2026-08

Code	Service	Rate	Unit
97151	Behavior identification assessment by professional · Covered from age 1. No prior authorization. The manual caps assessment at one per member, up to 24 units.	$37.51	15 min
97153	Adaptive behavior treatment by technician using an established plan · Prior authorization required.	$19.67	15 min
97154	Adaptive behavior treatment by technician with multiple patients · Prior authorization required.	$13.91	15 min
97155	Adaptive behavior treatment by professional using an established plan · Prior authorization required. Utah splits supervision: 97155 is for direct case supervision and HCPCS H0032 for indirect, each with a credential modifier — HP for a psychologist or BCBA-D, HO for a BCBA, HN for a behavior analyst in training or BCaBA.	$37.51	15 min
97156	Adaptive behavior treatment by professional with family · Prior authorization required.	$37.51	15 min
H0032	Mental health service plan development by non-physician — Utah's code for indirect ABA case supervision · Included because the provider manual makes 97155 and H0032 a paired billing rule. No time unit is printed in the record's procedure name.	$37.51	not stated

Read before using these numbers

97152, 0362T and 0373T are marked not covered. Utah's look-up tool returns 'non-covered service for this PAC' for each. 0362T and 0373T carry a residual charge factor of $16.41 in the underlying data, but the code is non-covered, so no rate is published for them here.
97157 and 97158 are marked covered but carry a charge factor printed as $.00, on records last touched in 2023. A zero there is not a reimbursement rate — Utah publishes no dollar figure for these two codes, and they are omitted rather than shown as $0.00.
Utah does not publish a standalone ABA fee schedule document. Rates come from a dynamic look-up generated per date of service; the figures here were generated for 4 August 2026 under both the Traditional plan and Provider Allowable Code 166, which returned identical amounts.
A rate increase took effect on 1 July 2026. Querying the same tool for 30 June 2026 returns the prior figures — 97151 and 97155 and 97156 at $36.84, 97153 at $19.32, 97154 at $13.66 — which confirms both the increase and that this is the current schedule.
The dollar figures come from the column headed 'Charge Factor'. The adjacent prior-authorization limit, copayment and post-operative day columns are not rates.
Scope limits printed by the agency: this schedule does not apply to hospital outpatient services paid under OPPS, to Indian Health Services, to school-based skills development, or to Utah's home and community based services waivers, and it excludes rural and other charge-factor enhancements.
Members may be enrolled with managed care entities, accountable care organizations or prepaid mental health plans whose payment can differ from these fee-for-service amounts.
An older legacy version of the same look-up tool is still online and returns superseded 2022-era figures. It was not used.

Official sources

Utah Medicaid Coverage and Reimbursement Code Look-Up and fee schedule download — Utah Department of Health and Human Services, Bureau of Coverage and Reimbursement Policy; records generated under Provider Allowable Code 166, Applied Behavioral Analyst Utah Medicaid Provider Manual — Autism Spectrum Disorder Services, updated January 2026 (Chapter 12 confirms the code set, the 15-minute units and the 97155/H0032 supervision billing rule)

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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