Most ABA billing mistakes are not typos. They come from a code that means something slightly different from what the person billing it assumed, or from a payer that reads the same code differently from the payer next door. This is a plain language guide to the adaptive behavior codes in use through December 31, 2026, who usually renders each one, and where payers disagree.
Every code in the set is billed in 15 minute units. The official descriptors are published by the AMA and are not reproduced here. What follows is our summary of the ABA Coding Coalition's guidance, which is worth reading in full.
| Code | Who renders it | What it covers |
|---|---|---|
| 97151 | The qualified professional, usually the BCBA | Assessment, including the only non face to face time in the set: reviewing records, scoring, and writing the treatment plan or progress report |
| 97152 | A technician, directed by the BCBA | Supporting assessment, face to face with one client. The technician follows procedures the BCBA chose and trained them on |
| 0362T | Technicians, with the BCBA on site | Supporting assessment for destructive behavior, needing two or more technicians and an environment set up for that behavior |
| 97153 | A technician, directed by the BCBA | Treatment following an existing protocol, face to face with one client |
| 97154 | A technician | The same treatment delivered to a group, billed for each client in the group |
| 97155 | The BCBA | Treatment where the BCBA modifies a protocol, either working with the client directly or directing a technician during the session |
| 97156 | The BCBA | Guidance for the family of one client, with or without the client present |
| 97157 | The BCBA | Guidance for a group of families without the clients present, billed once per family |
| 97158 | The BCBA | Group treatment with protocol modification, billed per client |
| 0373T | Technicians, with the BCBA on site | Treatment for destructive behavior with the same four requirements as 0362T, billing one technician's time only |
Two things catch people out. Writing or rewriting protocols away from the client is not billable under 97155; that work is bundled into the treatment codes. And there is no CPT code for indirect BCBA time such as reviewing data or preparing for a session, although some payers accept HCPCS codes for it. That is one of the things 2027 changes: the new set adds a code for that work.
The Coalition's guidance says 97155 can be billed at the same time as 97153 when a BCBA is directing a technician through a modified protocol, as long as one person is not billing both codes. Payers do not all agree.
Group size differs too. For the current set the Coalition and BCBS of Texas describe a group as two to eight clients, while Florida Medicaid caps group codes at six. From January 2027 the Coalition removes the ceiling of eight and leaves the size to the professional’s judgement, so a payer policy written against the old limit will outlive the rule it came from.
The AMA's time rule lets a 15 minute code be billed once at least half the unit, 8 minutes, has been delivered, counted per code. The CMS 8 minute rule was written for Medicare outpatient therapy and pools minutes across the day before converting them to units. Some payers apply a version of the CMS approach to ABA: BCBS of Texas uses a similar unit table, and Texas Medicaid totals a client's billable minutes for the day, divides by 15, and counts a remainder over 7 minutes as a unit. The same afternoon of sessions can produce a different number of units depending on the payer, so the rule has to come from each payer's policy, not from habit.
CPT® is a registered trademark of the American Medical Association. This article is general information, not billing or legal advice. Your payer contracts and provider manuals control.