A plain-English 2026 reference to ABA CPT codes: 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, plus Category III 0362T and 0373T, common modifiers, and 15-minute unit billing. Verify rates with your payer.
Frequently asked questions
What are the main ABA CPT codes?
The core ABA codes are 97151 and 97152 (assessment), 97153 (RBT direct treatment by protocol), 97154 (group treatment), 97155 (BCBA protocol modification), 97156 (family guidance), 97157 (multiple-family group guidance), and 97158 (group treatment by BCBA), plus Category III codes 0362T and 0373T. Most direct-service codes are billed in 15-minute units. This is general information, not billing advice — verify with your MAC or payer.
Are ABA CPT codes billed in 15-minute units?
Most ABA direct-service and assessment codes are reported in 15-minute units. The exact units, daily caps, and rounding rules vary by payer, so always confirm against your payer policy.
What is the difference between 97153 and 97155?
97153 is direct adaptive behavior treatment delivered by a technician (RBT) following the protocol the BCBA designed. 97155 is treatment delivered by the BCBA that includes modifying the protocol; the two can overlap during a session, subject to payer rules on concurrent billing.
What are 0362T and 0373T?
0362T and 0373T are AMA Category III (emerging-technology) codes. 0362T covers a behavior identification supporting assessment with on-site direction; 0373T covers exposure-style adaptive behavior treatment requiring two or more technicians for safety. Both are timed and payer-specific.
Which modifiers are used with ABA CPT codes?
Common modifiers include provider-level modifiers (HO, HN, HM), telehealth modifiers (95, GT), state-defined Medicaid modifiers (U1–U9), and distinct-service modifiers (59, XP, XS). Modifier requirements differ significantly by payer and state — verify before submitting.
How does Wilma handle ABA CPT codes?
Wilma encodes the ABA CPT and Category III code set with the correct time units and per-payer modifier rules. Sessions captured on the schedule convert into coded claims, and with the AI add-on each claim is scrubbed against payer rules before it ships. Codes and reimbursement vary by payer, so Wilma applies the rule pack that matches yours.