New Mexico Medicaid ABA Rates: 97153 and Every ABA Code \| StreamABA [ ![StreamABA](https://streamaba.com/build/assets/logo-dark-Bta4omRy.svg) ](/) [Home](https://streamaba.com) [Blog](https://streamaba.com/blog) [ Log in ](https://streamaba.com/login) [ Goto the Live Demo ](#get-started) [Home](https://streamaba.com) [Blog](https://streamaba.com/blog) [Log in](https://streamaba.com/login) [ Goto the Live Demo ](#get-started) ABA Medicaid rates · New Mexico New Mexico Medicaid *ABA rates.* ================================== New Mexico Medicaid (Turquoise Care) Fee-for-Service ABA. Fee-for-service rates as the state publishes them, with the source and the date we last checked it. Website Work email Goto the Live Demo Rates by code What New Mexico Medicaid *pays.* -------------------------------- Published. The state publishes a fee-for-service rate for these codes. Code Modifier / provider tier Unit Rate 97151 Behavior identification assessment (QHP) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. 15 min $130.94 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $130.94 BCBA (445/099) · Modifier U3 Prior auth: no. 15 min $112.65 97152 Supporting assessment (technician) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. 15 min $65.47 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $65.47 BCBA (445/099) · Modifier U3 Prior auth: no. 15 min $58.33 0362T Supporting assessment for severe behavior (team) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. 15 min $130.94 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $130.94 BCBA (445/099) · Modifier U3 Prior auth: no. 15 min $112.29 97153 Adaptive behavior treatment by protocol (technician) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: yes. 15 min $38.02 BCBA-D (445/099) · Modifier U4 Prior auth: yes. 15 min $37.99 BCBA (445/099) · Modifier U3 Prior auth: yes. 15 min $32.31 BCaBA (430/151) · Modifier U9 Prior auth: yes. 15 min $23.35 Behavior Technician, with or without bachelor's (430/098) · Modifier U1 Prior auth: yes. 15 min $19.85 97154 Group treatment by protocol (technician) Qualifying Psychologist (431/150) · Modifier UA U5 UA = group of 2-4; per recipient, billed on separate claims. Prior auth: no. 15 min $21.88 BCBA-D (445/099) · Modifier UA U4 UA = group of 2-4; per recipient, billed on separate claims. Prior auth: no. 15 min $21.88 BCBA (445/099) · Modifier UA U3 UA = group of 2-4; per recipient, billed on separate claims. Prior auth: no. 15 min $18.59 BCaBA (430/151) · Modifier UA U9 UA = group of 2-4; per recipient, billed on separate claims. Prior auth: no. 15 min $13.43 Behavior Technician, with or without bachelor's (430/098) · Modifier UA U1 UA = group of 2-4; per recipient, billed on separate claims. Prior auth: no. 15 min $11.43 Qualifying Psychologist (431/150) · Modifier UB U5 UB = group of 5-8; per recipient, billed on separate claims. Prior auth: no. 15 min $21.88 BCBA-D (445/099) · Modifier UB U4 UB = group of 5-8; per recipient, billed on separate claims. Prior auth: no. 15 min $21.88 BCBA (445/099) · Modifier UB U3 UB = group of 5-8; per recipient, billed on separate claims. Prior auth: no. 15 min $18.59 BCaBA (430/151) · Modifier UB U9 UB = group of 5-8; per recipient, billed on separate claims. Prior auth: no. 15 min $13.43 Behavior Technician, with or without bachelor's (430/098) · Modifier UB U1 UB = group of 5-8; per recipient, billed on separate claims. Prior auth: no. 15 min $11.43 97155 Treatment with protocol modification (QHP) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. 15 min $55.55 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $55.55 BCBA (445/099) · Modifier U3 Prior auth: no. A BCaBA may bill under the supervising BA's U3 modifier at the BA rate. 15 min $39.69 97156 Family treatment guidance (QHP) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. One unit per family set. 15 min $35.79 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $35.79 BCBA (445/099) · Modifier U3 Prior auth: no. A BCaBA may bill under the supervising BA's U3 modifier at the BA rate. 15 min $25.78 97157 Multiple-family group guidance (QHP) Qualifying Psychologist (431/150) · Modifier U5 Prior auth: no. Per recipient, separate claims. 15 min $71.43 BCBA-D (445/099) · Modifier U4 Prior auth: no. 15 min $71.43 BCBA (445/099) · Modifier U3 Prior auth: no. 15 min $51.59 97158 Group treatment with protocol modification (QHP) Qualifying Psychologist (431/150) · Modifier UA U5 UA = social skills group of 2-4; per recipient, separate claims. Prior auth: no. 15 min $15.88 BCBA-D (445/099) · Modifier UA U4 UA = social skills group of 2-4; per recipient, separate claims. Prior auth: no. 15 min $15.88 BCBA (445/099) · Modifier UA U3 UA = social skills group of 2-4; per recipient, separate claims. Prior auth: no. 15 min $12.69 Qualifying Psychologist (431/150) · Modifier UB U5 UB = social skills group of 5-8; per recipient, separate claims. Prior auth: no. per session (as printed; the 2-4 group row says 15 min) $15.88 BCBA-D (445/099) · Modifier UB U4 UB = social skills group of 5-8; per recipient, separate claims. Prior auth: no. per session (as printed; the 2-4 group row says 15 min) $15.88 BCBA (445/099) · Modifier UB U3 UB = social skills group of 5-8; per recipient, separate claims. Prior auth: no. per session (as printed; the 2-4 group row says 15 min) $12.69 0373T Treatment for severe behavior (team) Qualifying Psychologist (431/150) · Modifier U5 Specialty care; Prior auth: yes. One unit covers all BTs/BAAs/BAs; only the Specialty Care Practitioner bills. 15 min $119.05 BCBA-D (445/253, specialty care) · Modifier U4 Prior auth: yes. 15 min $119.05 BCBA (445/253, specialty care) · Modifier U3 Prior auth: yes. 15 min $107.13 How we read this state's schedule --------------------------------- The current file linked from HCA's Fee Schedules page is the schedule effective 1/1/25 (direct file URL served via a document service: https://api.realfile.rtsclients.com/PublicFiles/6c91aefc960e463485b3474662fd7fd2/4348fdf6-7595-4919-a7d7-738d9581b5bf/Applied%20Behavioral%20Analysis%20(ABA)%20Fee%20Schedule). Letter of Direction #53 (March 21, 2025, https://www.hca.nm.gov/wp-content/uploads/FInal-LOD-53-Applied-Behavioral-Analysis-ABA-Fee-Schedule-Rates.pdf) directs Turquoise Care MCOs to pay no less than these FFS rates. First modifier identifies credential (U5 Qualifying Psychologist, U4 BCBA-D, U3 BCBA, U9 BCaBA, U1 Behavior Technician); group size modifiers UA (2-4) and UB (5-8). Numbers in parentheses are NM provider type/specialty codes as printed. The schedule also includes non-CPT ABA codes (T1026 variants for evaluations, clinical management and case supervision) not captured here. Program New Mexico Medicaid (Turquoise Care) Fee-for-Service ABA Effective date 2025-01-01 Last reviewed 2026-09-30 Source [Updated: Applied Behavior Analysis (ABA) Fee Schedule for Medicaid Fee for Service, Effective 1/1/25 (HCA Fee Schedules page, 'Applied Behavioral Analysis (ABA) Fee Schedule' file)](https://www.hca.nm.gov/providers/fee-schedules/) National median · 97153 $15.04 per 15-min unit New Mexico: $19.85 at the same tier. Across 40 states, at the technician tier or the single rate where a state has no tiers. [How we count](https://streamaba.com/tools/aba-medicaid-rates#methodology) [Compare every state](https://streamaba.com/tools/aba-medicaid-rates) Read this before you rely on a number ------------------------------------- - These are New Mexico Medicaid fee-for-service rates as published by the state. They are not commercial insurance rates and not managed care plan rates. - This page is general information, not billing, coding or legal advice. - Fee schedules change, often without notice. Verify every rate with the state Medicaid agency, or with the plan you bill, before you rely on it. - CPT is a registered trademark of the American Medical Association. Code names here are our own short descriptions. Spotted a change or an error? [Tell us](https://streamaba.com/support) and we will re-check the source. 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