ABA Medicaid Rates: Virginia

Virginia DMAS Procedure Fee File — Medical, Part 4 (CPT codes 80002-99607), published on the Procedure Fee Fil

Effective per-code dates; outpatient tiers 2021-12-01 LAST CHECKED 2026-08

Code	Service	Rate	Unit
97151	BHV ID ASSMT BY PHYS/QHP — category "U1 HN NOM", outpatient · Effective 12/01/2021, end date 12/31/9999.	$23.48	not stated
97151	BHV ID ASSMT BY PHYS/QHP — category "U2 TF UG GO H", outpatient · Effective 12/01/2021, end date 12/31/9999.	$39.40	not stated
97151	BHV ID ASSMT BY PHYS/QHP — category "U3 U7 HO HK", outpatient · Effective 12/01/2021, end date 12/31/9999.	$46.63	not stated
97151	BHV ID ASSMT BY PHYS/QHP — category "REGULAR & CSB", inpatient · Effective 07/01/2026. Down from $10.25 (SFY26) and $14.95 (SFY25) — a documented year-on-year cut, confirmed in the DMAS audit-trail file.	$6.75	not stated
97152	BHV ID SUPRT ASSMT BY 1 TECH — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$23.48	not stated
97152	BHV ID SUPRT ASSMT BY 1 TECH — category "HK&HN HTU432N", outpatient · Effective 12/01/2021.	$15.00	not stated
97152	BHV ID SUPRT ASSMT BY 1 TECH — category "REGULAR & CSB", inpatient · Effective 07/01/2026.	$5.46	not stated
97153	ADAPTIVE BEHAVIOR TX BY TECH — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$23.48	not stated
97153	ADAPTIVE BEHAVIOR TX BY TECH — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$39.40	not stated
97153	ADAPTIVE BEHAVIOR TX BY TECH — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$46.63	not stated
97153	ADAPTIVE BEHAVIOR TX BY TECH — category "HK&HN HTU432N", outpatient · Effective 12/01/2021. No "REGULAR & CSB" row is currently active for 97153.	$15.00	not stated
97154	GRP ADAPT BHV TX BY TECH — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$15.60	not stated
97154	GRP ADAPT BHV TX BY TECH — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$13.13	not stated
97154	GRP ADAPT BHV TX BY TECH — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$15.55	not stated
97154	GRP ADAPT BHV TX BY TECH — category "HK&HN HTU432N", outpatient · Effective 12/01/2021.	$12.77	not stated
97155	ADAPT BEHAVIOR TX PHYS/QHP — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$23.48	not stated
97155	ADAPT BEHAVIOR TX PHYS/QHP — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$39.40	not stated
97155	ADAPT BEHAVIOR TX PHYS/QHP — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$46.63	not stated
97156	FAM ADAPT BHV TX GDN PHY/QHP — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$23.48	not stated
97156	FAM ADAPT BHV TX GDN PHY/QHP — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$39.40	not stated
97156	FAM ADAPT BHV TX GDN PHY/QHP — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$46.63	not stated
97156	FAM ADAPT BHV TX GDN PHY/QHP — category "REGULAR & CSB", inpatient · Effective 07/01/2026.	$6.56	not stated
97157	MULT FAM ADAPT BHV TX GDN — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$7.83	not stated
97157	MULT FAM ADAPT BHV TX GDN — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$13.13	not stated
97157	MULT FAM ADAPT BHV TX GDN — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$15.55	not stated
97157	MULT FAM ADAPT BHV TX GDN — category "REGULAR & CSB", inpatient · Effective 07/01/2026.	$1.52	not stated
97158	GRP ADAPT BHV TX BY PHY/QHP — category "U1 HN NOM", outpatient · Effective 12/01/2021.	$22.83	not stated
97158	GRP ADAPT BHV TX BY PHY/QHP — category "U2 TF UG GO H", outpatient · Effective 12/01/2021.	$28.13	not stated
97158	GRP ADAPT BHV TX BY PHY/QHP — category "U3 U7 HO HK", outpatient · Effective 12/01/2021.	$30.54	not stated

Read before using these numbers

DO NOT PUBLISH THESE AS 15-MINUTE RATES. The DMAS Procedure Fee File has no unit column and its published field-definition FAQ defines Maximum Rate only as "Amount allowable to be paid to a physician for a procedure or service". If $46.63 for 97153 were a 15-minute unit it would be $186.52 an hour, which is not plausible; if it is hourly it is. We could not establish which, so we report the figure and not a unit.
The category labels are quoted exactly as DMAS prints them: "REGULAR & CSB", "U1 HN NOM", "U2 TF UG GO H", "U3 U7 HO HK", "HK&HN HTU432N". They are modifier groupings under CAT TYPE "REG" (Regular). DMAS's own field-definition FAQ lists CAT TYPE codes but does not define these sub-labels, so we do not assert which provider tier each corresponds to. Any mapping to BCBA / BCaBA / RBT would be a guess.
The previously cited URL (https://www.dmas.virginia.gov/for-providers/rates-and-rate-setting/) is a rate-setting hub containing DME, hospital, waiver, hospice and home-health files and no ABA rates at all. The ABA rates are two clicks away in the Procedure Fee Files.
0362T and 0373T do not appear in the Virginia file.
Rows were selected using DMAS's own documented method: filter on the code, then on Rate End Date (END DATE) equal to 12/31/9999 to get the current rate.
The four "REGULAR & CSB" inpatient rows were cut sharply effective 07/01/2026 (97151 $10.25 to $6.75; 97152 $8.29 to $5.46; 97156 $9.97 to $6.56; 97157 $2.31 to $1.52). These reductions are independently recorded in the DMAS audit-trail file with timestamps of 2026-07-15.
The CSV and TXT versions of Part 4 are byte-identical, so they are one source, not two. The second read used a different mechanism entirely (see confidence).
DMAS notes that "rates listed on the Procedure Fee Files may be the same as or different from those paid to providers as some providers enrolled with Virginia Medicaid are paid a percentage of the total rate listed", and most Virginia ABA is delivered through Cardinal Care managed care.

Official sources

Virginia DMAS Procedure Fee File — Medical, Part 4 (CPT codes 80002-99607), published on the Procedure Fee Files & CPT Codes page

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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