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ABA therapy billing with authorizations that never run out unnoticed
Billing for applied behavior analysis providers.
How ABA therapy billing works
ABA services use the adaptive behavior codes 97151–97158, billed in 15-minute units. Most payers require prior authorization for both the assessment and the treatment plan, with a set number of hours for each service code.
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The biggest ABA revenue risks are units billed beyond the authorization, authorizations that expire before reauthorization, and the wrong rendering provider for a service performed by a technician.
Codes we bill every day
| Code | What it covers |
|---|---|
| 97151 | Behavior identification assessment by a qualified professional (BCBA) |
| 97152 | Supporting assessment administered by a technician |
| 97153 | Adaptive behavior treatment by protocol, by a technician (RBT) |
| 97154 | Group treatment by protocol, by a technician |
| 97155 | Treatment with protocol modification by a qualified professional |
| 97156 | Family adaptive behavior treatment guidance |
| 97157 | Multiple-family group guidance |
| 97158 | Group treatment with protocol modification |
Some state Medicaid programs use their own HCPCS codes or modifiers for ABA instead of, or alongside, 97151–97158. We follow your state’s rules.
Denials we prevent
- Units billed beyond the authorized hours
- Authorization expired before reauthorization was approved
- Technician services billed without the required supervising BCBA
- Missing provider credentials or modifiers required by the state
- Overlapping services billed at the same time without payer approval
Payer rules to watch
Each payer sets its own rules for who can be the rendering provider, which modifiers identify the technician level (for example HN, HO or HM in some Medicaid programs) and how much concurrent supervision can be billed. We set these up per payer before your first claim.
Questions about ABA therapy billing
Do you track authorization units?
Yes. We track units used against each authorization and alert you before hours or dates run out, so reauthorization is requested in time.
Do you bill Medicaid ABA?
Yes, including state-specific codes and modifiers where Medicaid requires them.
Get a free ABA therapy billing audit
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.