Code Reference

ABA Therapy Billing Codes: CPT 97151–97158, 0362T and 0373T

What each adaptive behavior code covers, who can bill it, how units and telehealth work, and the denials to watch for. Updated November 2026.

Quick Answer

ABA therapy is billed with the adaptive behavior CPT codes 97151–97158, each reported in 15-minute units. Technicians such as RBTs deliver 97152, 97153 and 97154 under a BCBA's direction. The BCBA or other qualified professional bills assessment (97151), protocol modification (97155, 97158) and family guidance (97156, 97157). Codes 0362T and 0373T cover destructive behavior. Who can render each code, unit limits, authorization and telehealth rules are set by each payer.

The ABA Therapy Codes at a Glance

All codes are reported in 15-minute units. The descriptions below are plain-English summaries, not the official CPT® descriptors.

Code	What it covers	Who performs it	Notes
97151	Behavior identification assessment	BCBA or other qualified professional	Face-to-face assessment plus some non-face-to-face time for scoring, analysis and the treatment plan
97152	Behavior identification supporting assessment	One technician (RBT), directed by the qualified professional	Gathers more information for the assessment; face-to-face time only
0362T	Supporting assessment for destructive behavior	Two or more technicians, qualified professional on site	For behavior with a high risk of injury or property damage, in a setting customized to the behavior
97153	Adaptive behavior treatment by protocol, one patient	Technician (RBT), directed by the qualified professional	The core one-on-one ABA session code. A BCBA who personally delivers the session also uses 97153.
97154	Group treatment by protocol	Technician	Two or more patients, up to 8
97155	Treatment with protocol modification	BCBA or other qualified professional	Patient present; covers directing the technician and adjusting the protocol
97156	Family adaptive behavior treatment guidance	BCBA or other qualified professional	Caregiver training, with or without the patient present; include caregiver goals in the treatment plan
97157	Multiple-family group guidance	BCBA or other qualified professional	Patient not present; up to 8 families
97158	Group treatment with protocol modification	BCBA or other qualified professional	Two or more patients, up to 8
0373T	Treatment with protocol modification for destructive behavior	Two or more technicians, qualified professional on site	One patient; customized setting

Who Can Bill: BCBA, BCaBA and RBT

BCBA (Board Certified Behavior Analyst). Usually the "qualified health care professional" who renders 97151, 97155, 97156, 97157 and 97158, but confirm that each payer accepts a BCBA in that role. Some states also license behavior analysts; check your state board and each payer's credentialing rules.
BCaBA (assistant behavior analyst). Payers differ on which codes a BCaBA may render. Check the payer's policy before scheduling a BCaBA on qualified-professional codes.
RBT (Registered Behavior Technician). Delivers the technician codes 97152, 97153 and 97154 under the direction of a qualified professional. The BACB requires RBTs to be supervised for at least 5% of their service hours each calendar month, with at least two face-to-face contacts, one of them individual. Phone and email don't count, but the observation can be done by video.

Payers also differ on whose NPI goes in the rendering provider field for technician codes: the RBT, the supervising BCBA, or the group. Get this from each payer in writing before the first claim.

Time and Units

Each unit is 15 minutes. Check each payer's rule for partial units.
Bill only face-to-face time, except 97151, which includes some non-face-to-face time for analyzing data, scoring and preparing the report and treatment plan.
Group codes 97154 and 97158 are limited to 8 patients, and 97157 to 8 families.
Payers differ on whether 97155 can be billed for the same time as a technician's 97153 (the BCBA directing the session while the RBT delivers it). Check the payer policy before billing overlapping time.
Daily and weekly limits, and medically unlikely edits, vary by payer and state program.

Destructive Behavior Codes: 0362T and 0373T

These codes are for patients whose behavior carries a high risk of medical consequences or property damage, such as self-injury needing medical attention or aggression that injures others. Both require two or more technicians, with the qualified professional on site, meaning immediately available to help throughout, though not necessarily in the room. Services take place in a setting customized to the patient's behavior.

Coverage and Authorization

Medicaid. For people under 21, Medicaid's EPSDT benefit requires states to cover medically necessary services within the federal Medicaid service categories. CMS explained how this applies to autism services in a July 7, 2014 bulletin. Each state sets its own provider types, codes, rates, limits and authorization rules, and some use state-specific codes; see your state billing guide and the state's manual.

Commercial plans. Coverage depends on the plan and on state law. Verify ABA benefits, visit or hour limits and authorization rules at intake; see the eligibility verification guide.

Authorization. Check whether each plan requires prior authorization for the assessment and for treatment hours, and track the approved codes, units and end dates. Reassess and update the treatment plan on the schedule each payer sets. See the prior authorization guide.

Telehealth

Place of service: CMS defines POS 02 as telehealth provided other than in the patient's home and POS 10 as telehealth in the patient's home. Use the one the payer requires.
Modifier: some payers also require a telehealth modifier such as 95. See the modifier reference.
Allowed codes: payers decide which ABA codes they accept by telehealth. Colorado Medicaid, for example, allows POS 02 only for codes on its telemedicine list. Confirm each code with each payer before scheduling telehealth sessions.

Common ABA Denials and Fixes

Denial	Typical cause	Fix
CO-197	No authorization on file for the code or date	Check the authorization covers the exact code, units and dates; request retro-authorization if the payer allows it
CO-198	Units billed over the authorized amount	Track units used against units approved each week; request more units before they run out
CO-151	The payer says the information sent doesn't support this many units or this frequency	Check the payer's unit limits, then appeal with session notes that support the units billed, or correct the units if they were wrong
CO-119	Annual benefit maximum reached	Confirm remaining benefits at intake and before each authorization period
CO-16	Missing or invalid information, often rendering or supervising provider fields	Match the payer's rendering-provider rule for technician codes and resubmit

Worked Example: A Week of ABA Claims

Illustrative, not client data

A child with an autism diagnosis has an authorization for 20 hours a week of 97153, 2 hours a week of 97155 and 1 hour a week of 97156, valid for six months.
An RBT delivers 4 hours of one-on-one sessions on five days: 80 units of 97153 for the week. The payer requires the supervising BCBA as rendering provider, so the claim lists the BCBA's NPI.
The BCBA spends 2 hours directing sessions and adjusting the protocol with the child present: 8 units of 97155. This payer allows 97155 to overlap 97153, so both are billed.
The BCBA meets the parents for 1 hour of caregiver training by video from home: 4 units of 97156 with POS 10, which this payer accepts for 97156.
Billing records units used against the authorization each week and requests the next authorization before the end date.

Frequently Asked Questions

The adaptive behavior codes are 97151 to 97158, billed in 15-minute units: 97151 and 97152 for assessment, 97153 and 97154 for treatment by protocol delivered by a technician, 97155 for treatment with protocol modification by a qualified professional, 97156 and 97157 for family guidance, and 97158 for group treatment with protocol modification. 0362T and 0373T cover assessment and treatment for destructive behavior.

A registered behavior technician delivers the technician codes: 97152 (supporting assessment), 97153 (one-on-one treatment by protocol) and 97154 (group treatment by protocol), under the direction of a BCBA or other qualified professional. Whether the RBT or the supervising provider appears as rendering provider on the claim depends on the payer.

Codes performed by a physician or other qualified health care professional, a role usually filled by a BCBA if the payer accepts it: 97151 (assessment), 97155 (protocol modification), 97156 and 97157 (family guidance) and 97158 (group protocol modification). A BCBA who personally delivers one-on-one treatment by protocol bills 97153.

The BACB requires RBTs to be supervised for at least 5% of the hours they provide behavior-analytic services each calendar month, including at least two face-to-face contacts, one of them individual. Supervision can't be by phone or email. Payers may set their own supervision rules on top of this.

It depends on the payer. Use place of service 02 or 10 as the payer requires (10 means the patient is at home), plus any telehealth modifier the payer asks for, and check which codes the payer allows by telehealth. Colorado Medicaid, for example, allows POS 02 only for codes on its telemedicine list.

For children and young people under 21, Medicaid's EPSDT benefit requires states to cover medically necessary services that fall within federal Medicaid service categories. CMS explained in a July 2014 bulletin how this applies to autism services. Each state sets its own provider rules, codes, limits and authorization requirements.

By Ajay Pillai (CEO, Aayur Solutions) and the ABA team. Updated November 2026. CPT® codes and descriptors are copyright the American Medical Association; official descriptors and complete rules are in CPT® and payer policy. The American Billing Association is an educational billing resource and is not affiliated with any applied behavior analysis organization or with the BACB. This page is educational and doesn't replace a payer's policy.

Sources

ABA Claims Getting Denied?

Look Up the Denial Code → Behavioral Health Billing Guide