ABA Medicaid Rates: Wisconsin

ForwardHealth — Behavioral Treatment benefit, Wisconsin Department of Health Services, Division of Medicaid Services

Effective 2023-02-01 LAST CHECKED 2026-08

Code	Service	Rate	Unit
97151	Behavior identification assessment by a qualified health professional · All provider type 34 specialties. Claims require modifier TG for comprehensive or TF for focused treatment. Prior authorization required beyond 96 units a year.	$25.90	15 min
97152	Behavior identification supporting assessment by one technician · Limited to two hours per date of service.	$22.93	15 min
97153	Adaptive behavior treatment by protocol — technician level, and comprehensive treatment at any provider level · The handbook states the reimbursement rate for behavioral treatment technicians is the same for both focused and comprehensive treatment.	$11.91	15 min
97153 TF	Adaptive behavior treatment by protocol — focused, delivered by a licensed supervisor · Behavioral Treatment Licensed Supervisor or Focused Treatment Licensed Supervisor.	$41.44	15 min
97153 TF	Adaptive behavior treatment by protocol — focused, delivered by a therapist · Behavioral Treatment Therapist or Focused Treatment Therapist.	$20.84	15 min
97154	Group adaptive behavior treatment by protocol — licensed supervisor · Effective 1 December 2022. Limited to eight units per member per date of service; prior authorization required.	$12.71	15 min
97154	Group adaptive behavior treatment by protocol — therapist	$6.39	15 min
97154	Group adaptive behavior treatment by protocol — technician	$3.65	15 min
97155	Adaptive behavior treatment with protocol modification by a qualified health professional · Do not bill 97153 separately while simultaneously directing a technician.	$22.93	15 min
97156	Family adaptive behavior treatment guidance, also used for team meetings with modifier AM · Family guidance limited to eight units per date of service; team meetings limited to four units a week.	$28.03	15 min
97158	Group adaptive behavior treatment with protocol modification — licensed supervisor · Effective 1 December 2022.	$12.71	15 min
97158	Group adaptive behavior treatment with protocol modification — therapist · Technicians are not listed for this code.	$6.39	15 min

Read before using these numbers

There is no single rate for 97153, 97154 or 97158 in Wisconsin. What is paid depends on the rendering provider's enrolled specialty and, for 97153, on the modifier. A licensed supervisor delivering focused treatment under 97153 is paid $41.44 against a technician's $11.91 for the same code. Quoting one number for these codes would be wrong.
Wisconsin does not publish this schedule as a document. It is published as flat data files per service area plus an interactive search, reached after accepting a CPT license agreement.
The downloadable schedules are being discontinued. The ForwardHealth Portal carries a notice that the downloadable maximum allowable fee schedules end on 1 December 2026, after which only the interactive search remains. Expect any direct file link to break after that date.
97157 and 0362T are not priced. Neither appears on the behavioral treatment schedule, on any of the 48 downloadable service-area files, or in the interactive search for any service area.
0373T appears only on a separate miscellaneous schedule at $18.34 with a 2021 effective date, not on the behavioral treatment schedule and not in the behavioral treatment handbook. The code was deleted from CPT in 2019. It is best read as a residual file entry rather than a current ABA rate, and is not published above.
The fee schedule prints no time unit. The 15-minute unit comes from the ForwardHealth Online Handbook's behavioral treatment procedure code table, which prints 'each 15 minutes' in the descriptions, and from ForwardHealth Update 2022-54, which states the group codes are reimbursed in 15-minute units.
Behavioral treatment is a carve-out. ForwardHealth states it is an administered fee-for-service benefit for all Medicaid-enrolled members, separate from the managed care organizations — so unlike most states, these fee-for-service rates are the operative statewide rates rather than an unused schedule.
These are maximum allowable fees; Wisconsin reimburses the lesser of the billed amount or the maximum. All behavioral treatment codes require prior authorization.
The most recent behavioral treatment rate change was 1 February 2023, an 8.7 percent increase announced in ForwardHealth Update 2023-03. The group codes date from 1 December 2022. The rate increases under 2025 Wisconsin Act 15 effective January 2026 do not include behavioral treatment.

Official sources

Behavioral Treatment Maximum Allowable Fee Schedule, schedule as of 1 August 2026 — ForwardHealth, Wisconsin Department of Health Services (downloadable data file, reached from the ForwardHealth Portal's Downloadable Max Fee Schedules page) ForwardHealth Online Handbook, Behavioral Treatment benefit, published policy through 30 June 2026 — the source for the 15-minute unit and the TG, TF and AM modifier definitions ForwardHealth Max Fee Dynamic Search — the interactive tool that will remain after the downloadable schedules are discontinued

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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