BCBS Michigan reimbursement rates in Pennsylvania
BCBS Michigan's median rate for 97153 (one-on-one ABA therapy by a technician) in Pennsylvania is $22.20 per 15 min, across 5 published rates from 35 providers. That is 74% above Pennsylvania Medicaid's fee-for-service rate of $12.73.
- Codes with a median
- 70
- 97153 median
- $22.20per 15 min
- Files
- October 2026
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BCBS Michigan vs Pennsylvania Medicaid
For 97155 (ABA therapy led by the analyst (plan adjusted in session)), the median of BCBS Michigan's published Pennsylvania rates is $31.14 per 15 min (7 rates, 35 providers). That is 41% above Pennsylvania Medicaid's fee-for-service rate of $22.09. BCBS Michigan publishes Pennsylvania rates for 70 of the codes we track. Figures are from the October 2026 files.
| Code | BCBS Michigan median | Per hour | Pennsylvania Medicaid | TRICARE | Rates (n) |
|---|---|---|---|---|---|
| 97153One-on-one ABA therapy by a technician | $22.20per 15 min | $88.80 | $12.7374% above | — | 535 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $31.14per 15 min | $124.56 | $22.0941% above | — | 735 providers |
All 70 BCBS Michigan codes with a median in Pennsylvania
Frequently asked questions
What does BCBS Michigan pay for 97153 in Pennsylvania?
The median of BCBS Michigan's published Pennsylvania rates for 97153 is $22.20 per 15 min ($88.80 per hour), from 5 rates and 35 providers in the October 2026 files.
Does BCBS Michigan pay more than Pennsylvania Medicaid for 97153?
BCBS Michigan's median is 74% above the Medicaid fee-for-service rate of $12.73 per 15 min.
What does BCBS Michigan pay for 97155 in Pennsylvania?
The median of BCBS Michigan's published Pennsylvania rates for 97155 is $31.14 per 15 min ($124.56 per hour), from 7 rates and 35 providers in the October 2026 files.
Does BCBS Michigan pay more than Pennsylvania Medicaid for 97155?
BCBS Michigan's median is 41% above the Medicaid fee-for-service rate of $22.09 per 15 min.
How many codes does BCBS Michigan publish rates for in Pennsylvania?
70 of the behavioral health, ABA, therapy, home health and other codes we track have a BCBS Michigan median in Pennsylvania. The full list, with ranges and modifier tiers, is in the workspace.