How much does ABA therapy cost per hour?

There is no single hourly price, because ABA is billed in 15-minute units against several different CPT codes and every payer sets its own amount. Among the state Medicaid schedules we have read from the source documents, an hour of direct therapy (code 97153) is reimbursed between $48.72 in Kentucky and $74.80 in Nebraska. TRICARE's published maximum allowed amounts for the same code run considerably higher and vary by locality and provider tier.

Does insurance cover ABA therapy?

Usually, but the terms differ by plan type. Medicaid must cover medically necessary treatment for enrolled children under 21 under the EPSDT benefit, and most states require state-regulated commercial plans to cover autism treatment. Self-funded employer plans — which covered 67% of workers with employer coverage in 2025 — are generally exempt from state benefit mandates under ERISA, so what they cover is a matter of the plan document rather than state law.

What does Medicaid pay for ABA therapy?

It varies by state and provider credential. For code 97153, the direct treatment code that fills most of a child's week, the published fee-for-service rates we have verified range from $12.18 per 15-minute unit in Kentucky (effective 1 April 2026) to $18.70 in Nebraska (effective 1 August 2025). These are what the state pays the provider, not what a family pays.

How many hours a week of ABA therapy is typical?

The clearest published figure comes from the Department of Defense. Its August 2025 annual report on the Autism Care Demonstration found that weekly use of code 97153 peaked at an average of 9.9 hours per week for 4-year-olds, was 9.5 hours for 5-year-olds, declined consistently after age 5, and fell to 5.1 hours per week for beneficiaries aged 13 and older. Authorized hours are set case by case and can be well above or below those averages.

How much does ABA cost without insurance?

We cannot answer this from a published document. Private-pay rates are set provider by provider and almost none publish them, so any national private-pay range you see is an estimate rather than a schedule. What is publishable is the floor implied by public payers: the state Medicaid rates below are real, sourced numbers, and a private-pay quote can be compared against them.

What will I actually pay out of pocket?

The billed amount and your share are different numbers. Your share is set by the deductible, coinsurance and out-of-pocket maximum in your plan — the 2025 average annual deductible for single employer coverage was $1,886. For non-grandfathered plans, federal rules cap total in-network cost sharing for essential health benefits at $10,600 for self-only coverage and $21,200 for other than self-only coverage in the 2026 plan year.

How Much Does ABA Therapy Cost? What the Published Fee Schedules Actually Say

ABA is billed in 15-minute units against CPT codes, so there is no single price. Here are the real numbers from state Medicaid fee schedules and TRICARE's published rate table, with effective dates — and an honest account of the prices nobody publishes.

Search for what ABA therapy costs and you will find confident ranges — $60 to $250 an hour, $17,000 to $100,000 a year — on page after page, almost none of which say where the number came from. This page takes the opposite approach. Every figure below is read from a fee schedule or an official report, carries its effective date, and links to the document. Where a price is genuinely not published anywhere, this page says so instead of filling the space.

There is no single price, and the reason is structural

ABA is not billed as a session. It is billed in 15-minute units against separate CPT codes, each covering different work performed by a differently credentialed person. Four codes carry most of a treatment plan:

Code	What it covers	Who delivers it
97151	Behavior identification assessment — the intake evaluation and treatment plan	Behavior analyst
97153	Adaptive behavior treatment by protocol — the direct therapy hours	Technician (RBT)
97155	Treatment with protocol modification — the analyst adjusting the plan	Behavior analyst
97156	Family adaptive behavior treatment guidance — caregiver training	Behavior analyst

Our CPT code reference covers all eight codes and the modifier rules. The point for cost is that a week of ABA is a mix of these codes, each paying a different amount, multiplied by however many units the payer authorized. Change the hours, the code mix or the payer and the total changes. That is why no honest single price exists.

What Medicaid pays, state by state

These are fee-for-service rates for 97153, the direct treatment code, taken from each state’s own schedule. We re-read every one of these documents on 2 August 2026.

State	Per 15-minute unit	Per hour	Effective	Source
Nebraska	$18.70	$74.80	1 August 2025	schedule
Indiana	$16.04	$64.16	1 January 2024	schedule
Louisiana	$12.50	$50.00	1 July 2022	schedule
Florida	$12.19	$48.76	1 January 2025	schedule
Kentucky	$12.18	$48.72	1 April 2026	schedule

Five states out of the twenty-five in our reimbursement dataset publish a clean per-code table. The rest have a page and an official source but no extracted rate, and this table grows as those land. Read it as five data points, not a national picture — and note that the schedules span four years, so part of the spread between them is vintage rather than geography.

The direct therapy code is only one line of the bill. Here is the same five states across the four codes that matter most, per 15-minute unit:

State	97151 assessment	97153 treatment	97155 modification	97156 family guidance
Nebraska	$38.16 (per service, not per unit)	$18.70	$22.72	$26.06
Indiana	$21.87 – $27.63	$16.04	$21.85 – $27.63	$21.87 – $28.23
Louisiana	$25.00	$12.50	$22.50	$22.50
Florida	$19.05	$12.19	$15.37 – $19.17	$15.24 – $19.05
Kentucky	$19.25 – $27.50	$12.18	$19.25 – $27.50	$14.94 – $21.35

Ranges are credential tiers, not uncertainty: each state pays more when a behavior analyst delivers the service than when an assistant does. Nebraska bills 97151 per service rather than per 15 minutes, which is unusual and means that figure does not compare directly to the others. Louisiana also publishes reduced intermediate-care rates under the TF modifier, and Florida lists supervisee-rendered 97153 and 97155 under the XP modifier as not separately reimbursed.

What TRICARE publishes

TRICARE is the one payer other than Medicaid that publishes an ABA price list a member can look up. Its ABA Maximum Allowed Amounts, effective 1 May 2025, covers 97151, 97153, 97155, 97156, 97157 and 97158 across all 50 states, DC, Puerto Rico, the US Virgin Islands, Guam and selected overseas locations, at four provider tiers: BCBA-D/BCBA, BCBA, assistant behavior analyst and behavior technician.

Because it is locality- and tier-adjusted, TRICARE has no single number either. Across localities and tiers, the rates extracted onto our TRICARE page run $31.25 to $42.37 per 15-minute unit for 97153 and 97155 — roughly $125 to $169 an hour — and $31.25 to $51.75 for 97151 and 97156. One caveat worth stating: the numeric rate file sits behind an AMA CPT license acceptance page, so a reader can reach it but a link cannot show it directly.

A worked example, and what it is not

Below is an illustration. It is arithmetic on published rates, not a quote, not a bill, and not what any family will pay. It assumes a week of 10 hours of direct therapy (97153), 2 hours of protocol modification (97155) and 1 hour of family guidance (97156), annualized over 48 weeks.

The 10-hour figure is anchored on the clearest published utilization data available: the Department of Defense’s annual report on the Autism Care Demonstration, published August 2025, found that weekly use of 97153 peaked at an average of 9.9 hours per week for 4-year-olds and 9.5 hours for 5-year-olds, dropping consistently after age 5 to 5.1 hours per week for those aged 13 and older.

State	Billed per week	Billed per year (48 weeks)
Nebraska	$1,034.00	$49,632
Indiana	$1,016.36	$48,785
Louisiana	$770.00	$36,960
Kentucky	$792.60	$38,045
Florida	$719.96	$34,558

Where credential tiers exist, this uses the analyst-level rate for 97155 and 97156. Change any assumption — hours, code mix, tier, number of weeks — and every total moves. Nobody is authorized 10 hours because a table said so; hours are set case by case against medical necessity.

For a real published annual figure rather than a modeled one, the same DoD report gives an average cost per Autism Care Demonstration participant of $24,190 in FY 2022, rising 7.3 percent in FY 2023, across 16,747 participating beneficiaries and $434.6 million in total ABA spending at the end of FY 2023. That average spans all ages and all utilization levels, which is why it sits below a model built on a preschooler’s schedule.

What is not published, and we will not pretend otherwise

Commercial insurance negotiated rates are not public. What a health plan pays a specific ABA provider for 97153 is set in a contract between them. It is not filed publicly, not in any fee schedule, and not something we or anyone else can quote. Hospital price transparency rules do not reach most outpatient ABA providers.

Medicaid managed-care rates are usually not public either. Most Medicaid enrollment runs through managed care plans that negotiate their own rates against the published fee-for-service baseline. The schedules above are the floor of that conversation, not necessarily the contracted number. Some states constrain it: Indiana publishes its figures as a minimum schedule that plans must meet or exceed, and Nebraska adjusted managed care rates to match the state rates effective 1 August 2025.

Private-pay rates vary by provider and are rarely published. We are not going to convert that absence into a range. If you are quoted a private-pay rate, the tables above give you published public-payer rates to hold it against.

What families pay versus what is billed

The billed amount and the family’s share are different numbers, and the second is governed by plan design rather than by any fee schedule.

Medicaid. For children under 21 enrolled in Medicaid, the EPSDT benefit requires states to furnish all coverable, appropriate and medically necessary services needed to correct or ameliorate a condition — including services not otherwise in the state plan. Cost sharing in Medicaid is minimal or nil for children.

Commercial coverage. Three plan features determine the family’s share: the deductible, the coinsurance, and the annual out-of-pocket maximum. KFF’s 2025 Employer Health Benefits Survey put the average annual deductible for single coverage at $1,886. Above the deductible, coinsurance applies until the out-of-pocket maximum is reached. For non-grandfathered plans, CMS set the 2026 maximum annual limitation on cost sharing at $10,600 for self-only coverage and $21,200 for other than self-only coverage, rising to $12,000 and $24,000 in 2027 — the figures are stated in the agency’s 2027 premium adjustment percentage guidance of 29 January 2026. That cap is the practical ceiling on annual in-network cost sharing for covered essential health benefits, whatever the billed total.

State mandates, and their limit. The National Conference of State Legislatures maintains a table of state autism insurance statutes stating that “Most states require insurers to provide coverage for the treatment of autism.” That page was last updated 24 August 2021, and we did not find a current official national count, so we are not going to assert one. What matters more for most families is which plan they have: per KFF’s health insurance regulation primer of October 2025, “Most state insurance laws, including state benefit mandates, don’t apply to self-insured ERISA plans.” The same KFF survey found 67% of covered workers were in self-funded plans in 2025. For those families, coverage is set by the plan document, not the state mandate.

How to get your own number

Three questions produce a real answer where a national average cannot. What does the plan cover and at what cost sharing — from the summary of benefits, not from a phone call. How many units of which codes were authorized — from the authorization letter. And what the provider bills and collects for those codes. If the payer is Medicaid, start at your state’s page and the fee schedule behind it.

Every figure on this page is read from the linked document and stamped with its effective date. Corrections, and fee schedules we have not found yet: [email protected].