CareFirst BCBS ABA reimbursement rates in Pennsylvania
CareFirst BCBS pays a median of $24.46 per 15 min ($97.84 an hour) for ABA therapy by a technician (97153) in Pennsylvania, across 24 rates and 193 providers. That is 92% above Pennsylvania Medicaid ($12.73).
- 97153 median
- $24.46per 15 min
- 97155 median
- $32.61per 15 min
- Files
- October 2026
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CareFirst BCBS vs Pennsylvania Medicaid and TRICARE
CareFirst BCBS pays a median of $32.61 per 15 min ($130.44 an hour) for protocol modification by the analyst (97155) in Pennsylvania, across 24 rates and 193 providers. That is 48% above Pennsylvania Medicaid ($22.09). CareFirst BCBS pays 1.33 times as much for analyst time as for technician time in Pennsylvania. Figures come from CareFirst BCBS's October 2026 price-transparency files.
| Code | CareFirst BCBS median | Per hour | Pennsylvania Medicaid | TRICARE | Rates (n) |
|---|---|---|---|---|---|
| 97153One-on-one ABA therapy by a technician | $24.46per 15 min | $97.84 | $12.73 | — | 24193 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $32.61per 15 min | $130.44 | $22.09 | — | 24193 providers |
Every ABA code CareFirst BCBS publishes in Pennsylvania
Frequently asked questions
What does CareFirst BCBS pay for 97153 in Pennsylvania?
The median of CareFirst BCBS's published Pennsylvania rates for 97153 is $24.46 per 15 min ($97.84 per hour), from 24 rates and 193 providers in the October 2026 files.
What does CareFirst BCBS pay for 97155 in Pennsylvania?
The median of CareFirst BCBS's published Pennsylvania rates for 97155 is $32.61 per 15 min ($130.44 per hour), from 24 rates and 193 providers in the October 2026 files.
Does CareFirst BCBS pay more than Pennsylvania Medicaid for ABA?
For 97153, CareFirst BCBS's median is 92% above the Pennsylvania Medicaid fee-for-service rate of $12.73 per 15 min.