BCBS North Carolina reimbursement rates in Pennsylvania
Across 15 published rates from 50 providers, BCBS North Carolina pays a median of $34.01 per 15 min for 97153 (one-on-one ABA therapy by a technician) in Pennsylvania. That is 167% above Pennsylvania Medicaid's fee-for-service rate of $12.73.
- Codes with a median
- 75
- 97153 median
- $34.01per 15 min
- Files
- September 2026
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BCBS North Carolina vs Pennsylvania Medicaid
BCBS North Carolina's median rate for 97155 (ABA therapy led by the analyst (plan adjusted in session)) in Pennsylvania is $34.01 per 15 min, across 15 published rates from 50 providers. That is 54% above Pennsylvania Medicaid's fee-for-service rate of $22.09. BCBS North Carolina publishes Pennsylvania rates for 75 of the codes we track, across commercial, marketplace (aca) plans. Figures are from the September 2026 files.
| Code | BCBS North Carolina median | Per hour | Pennsylvania Medicaid | TRICARE | Rates (n) |
|---|---|---|---|---|---|
| 97153One-on-one ABA therapy by a technician | $34.01per 15 min | $136.04 | $12.73167% above | — | 1550 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $34.01per 15 min | $136.04 | $22.0954% above | — | 1550 providers |
All 75 BCBS North Carolina codes with a median in Pennsylvania
Frequently asked questions
What does BCBS North Carolina pay for 97153 in Pennsylvania?
The median of BCBS North Carolina's published Pennsylvania rates for 97153 is $34.01 per 15 min ($136.04 per hour), from 15 rates and 50 providers in the September 2026 files.
Does BCBS North Carolina pay more than Pennsylvania Medicaid for 97153?
BCBS North Carolina's median is 167% above the Medicaid fee-for-service rate of $12.73 per 15 min.
What does BCBS North Carolina pay for 97155 in Pennsylvania?
The median of BCBS North Carolina's published Pennsylvania rates for 97155 is $34.01 per 15 min ($136.04 per hour), from 15 rates and 50 providers in the September 2026 files.
Does BCBS North Carolina pay more than Pennsylvania Medicaid for 97155?
BCBS North Carolina's median is 54% above the Medicaid fee-for-service rate of $22.09 per 15 min.
How many codes does BCBS North Carolina publish rates for in Pennsylvania?
75 of the behavioral health, ABA, therapy, home health and other codes we track have a BCBS North Carolina median in Pennsylvania. The full list, with ranges and modifier tiers, is in the workspace.