97157 Medicaid reimbursement rates by state
ABA parent or caregiver training for several families. 16 state Medicaid programs publish a fee-for-service rate for 97157 at the analyst level. Rates run from $3.16 in Missouri to $26.12 in Massachusetts, with a median of $10.15.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $10.15units vary by state
- Highest
- $26.12Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
97157 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MassachusettsBehavior analyst (BCBA / licensed behavior analyst) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $26.12since 2024-10-01 | 15 min | $104.48 | Plans must pay at least this | — | Rates for Applied Behavior Analysis (eff |
| GeorgiaBehavior analyst (BCBA / licensed behavior analyst) · Georgia Medicaid (fee-for-service) | $17.51since 2025-07-01 | 15 min | $70.04 | Plans negotiate; applies out of network | — | Georgia Medicaid Autism Spectrum Disorde |
| South CarolinaBehavior analyst (BCBA / licensed behavior analyst) · South Carolina Healthy Connections Medicaid (fee-for-service) | $13.31since 2026-08-13 | 15 min | $53.24 | Not classified | — | SCDHHS ASD Services Fee Schedule |
| VirginiaBehavior analyst (BCBA / licensed behavior analyst) · Virginia Medicaid (fee-for-service, DMAS) | $13.13since 2021-12-01 | 15 min | $52.52 | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| MarylandBehavior analyst (BCBA / licensed behavior analyst) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $12.91since 2024-07-01 | 15 min | $51.64 | Paid by the state, outside plans | — | ABA Fee Schedule FY25 |
| New JerseyBehavior analyst (BCBA / licensed behavior analyst) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $12.40since 2025-01-01 | 15 min | $49.60 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaBehavior analyst (BCBA / licensed behavior analyst) · North Carolina Medicaid Direct (fee-for-service) | $11.51since 2025-10-01 | 15 min | $46.04 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'LCSW LCMHC LMF |
| WashingtonBehavior analyst (BCBA / licensed behavior analyst) · Washington Apple Health (Medicaid) fee-for-service | $10.34since 2026-01-01 | 15 minute units | $41.36 | Plans must pay at least this | — | HCA ABA fee schedule (aba-20260701.xlsx) |
| IndianaBehavior analyst (BCBA / licensed behavior analyst) · Indiana Medicaid (fee-for-service) | $9.95since 2026-10-01 | 15 min | $39.80 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| IllinoisBehavior analyst (BCBA / licensed behavior analyst) · Illinois Medicaid (HFS fee-for-service) | $9.00since 2022-01-15 | 1/4 hr | — | Plans negotiate; applies out of network | — | HFS Adaptive Behavior Support (ABS) Serv |
| LouisianaBehavior analyst (BCBA / licensed behavior analyst) · Louisiana Medicaid (fee-for-service) | $9.00since 2022-07-01 | 15 min | $36.00 | Plans must pay at least this | — | Louisiana Medicaid Applied Behavioral An |
| ArizonaBehavior analyst (BCBA / licensed behavior analyst) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $8.84since 2026-10-01 | 15 min | $35.36 | Plans negotiate; applies out of network | — | AHCCCS FFS Program Capped Fee Schedule: |
| KentuckyBehavior analyst (BCBA / licensed behavior analyst) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $8.48since 2020-01-01 | 15 min | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| MinnesotaBehavior analyst (BCBA / licensed behavior analyst) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $6.72since 2024-01-01 | 15 min | $26.88 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New YorkBehavior analyst (BCBA / licensed behavior analyst) · New York Medicaid (fee-for-service) | $3.31since 2023-04-01 | 15 min | $13.24 | Not classified | — | eMedNY NYS Medicaid Applied Behavior Ana |
| MissouriBehavior analyst (BCBA / licensed behavior analyst) · Missouri MO HealthNet (fee-for-service) | $3.16since 2025-12-18 | 15 min | $12.64 | Paid by the state, outside plans | — | MO HealthNet fee schedule: Applied Behav |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 97157?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $10.15. Massachusetts pays the most ($26.12 per 15 min) and Missouri the least ($3.16 per 15 min).
Which state pays the highest Medicaid rate for 97157?
Massachusetts, at $26.12 per 15 min ($104.48 per hour), effective 2024-10-01.
Do managed-care plans pay the same rate for 97157?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.