Vermont 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 · Vermont Vermont Medicaid *ABA rates.* =============================== Vermont Medicaid (DVHA) FFS - ABA benefit. 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 Vermont 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) BCBA (provider type T46 / specialty S50) Rate effective 01/01/2019, still current; record updated 2026-09-25. No PA; max units 16. Not authorized for telehealth. 15 min $65.80 97152 Supporting assessment (technician) All provider types (000) No PA; max units 16. Not authorized for telehealth. 15 min $30.00 97153 Adaptive behavior treatment by protocol (technician) All provider types (000) PA required; max units 32. From 1/1/2026 it cannot be billed at the same time as 97155. Not authorized for telehealth. 15 min $15.00 97154 Group treatment by protocol (technician) All provider types (000) Rate effective 06/01/2019. PA required; max units 18. 15 min $7.50 97155 Treatment with protocol modification (QHP) BCBA (T46/S50) PA required; max units 24. Telehealth allowed with modifier 95. BCaBAs may not bill it. 15 min $49.35 97156 Family treatment guidance (QHP) BCBA (T46/S50) PA required; max units 16. Telehealth allowed with modifier 95. 15 min $21.39 97157 Multiple-family group guidance (QHP) BCBA (T46/S50) PA required; max units 16. Telehealth allowed with modifier 95. 15 min $21.39 97158 Group treatment with protocol modification (QHP) BCBA (T46/S50) Rate effective 06/01/2019. PA required; max units 16. 15 min $16.45 0362T Supporting assessment for severe behavior (team) All provider types (000) No PA; max units 16. BCBA must be on site; counts as 1 member hour for tier selection. 15 min $52.00 0373T Treatment for severe behavior (team) All provider types (000) PA required; max units 32. A separate T46 line at $104.00 was end-dated 12/31/2025. For 2026 only this $26.00 line remains. 15 min $26.00 Caveats ------- - For Medicaid-primary members, the state pays a monthly ABA case rate by hours tier; these unit rates apply to FFS claims. How we read this state's schedule --------------------------------- Rates are from the official Vermont Medicaid portal fee schedule, queried per code for date of service 2026-09-30. The same rates return for 10/01/2026 and 01/01/2027. Line effective dates are 01/01/2019, or 06/01/2019 for 97154 and 97158. effective\_date 2026-01-01 marks the current DVHA ABA billing rules ('VT Medicaid ABA Coding Updates', Nov 10, 2025). Under those rules: HN/HO, group-size and 59/76/77 modifiers are retired. Modifier 95 (telehealth) is allowed only on 97155, 97156 and 97157. BCBAs (T46/S50) are paid 100% on all ABA codes. BCaBAs (T46/S51) are paid 100% on 97152, 97153 and 97154 only. 97153 and 97155 cannot be billed concurrently. Payment is not purely per unit. For Medicaid-primary members, DVHA pays a monthly ABA case rate by hour tier. Tiers effective 1/1/2026 run from Tier 1 (2-5.99 hrs) $219 to Tier 14 (170+ hrs) $13,667, reconciled against shadow claims. The unit rates apply to FFS claims, including Medicaid-secondary claims. The ABA Supplement (08-04-2026) says ABA is reimbursed FFS. The dvha.vermont.gov Codes/Fee Schedules page links to this portal as the fee schedule. Program Vermont Medicaid (DVHA) FFS - ABA benefit Effective date 2026-01-01 Last reviewed 2026-09-30 Source [Vermont Medicaid Fee Schedule - CPT Codes (vtmedicaid.com, Gainwell; data from /api/fsCpts/ for DOS 09/30/2026, records updated 2026-09-25)](https://www.vtmedicaid.com/#/feeSchedule/cptCodes) National median · 97153 $15.04 per 15-min unit Vermont: $15.00 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 Vermont 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. Live demo · No sales call Bill the rate you're actually owed. ------------------------------------- StreamABA keeps each payer's fee schedule, authorizations and claims in one place, so every session bills at the right rate. Get instant access to the live demo. No sales call, no meeting. 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