CareFirst BCBS reimbursement rates in Pennsylvania
CareFirst BCBS's median rate for 97153 (one-on-one ABA therapy by a technician) in Pennsylvania is $24.46 per 15 min, across 24 published rates from 193 providers. That is 92% above Pennsylvania Medicaid's fee-for-service rate of $12.73.
- Codes with a median
- 93
- 97153 median
- $24.46per 15 min
- Files
- October 2026
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CareFirst BCBS vs Pennsylvania Medicaid
For 97155 (ABA therapy led by the analyst (plan adjusted in session)), the median of CareFirst BCBS's published Pennsylvania rates is $32.61 per 15 min (24 rates, 193 providers). That is 48% above Pennsylvania Medicaid's fee-for-service rate of $22.09. CareFirst BCBS publishes Pennsylvania rates for 93 of the codes we track. Figures are from the October 2026 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 | $12.7392% above | — | 24193 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $32.61per 15 min | $130.44 | $22.0948% above | — | 24193 providers |
All 93 CareFirst BCBS codes with a median 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.
Does CareFirst BCBS pay more than Pennsylvania Medicaid for 97153?
CareFirst BCBS's median is 92% above the Medicaid fee-for-service rate of $12.73 per 15 min.
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 97155?
CareFirst BCBS's median is 48% above the Medicaid fee-for-service rate of $22.09 per 15 min.
How many codes does CareFirst BCBS publish rates for in Pennsylvania?
93 of the behavioral health, ABA, therapy, home health and other codes we track have a CareFirst BCBS median in Pennsylvania. The full list, with ranges and modifier tiers, is in the workspace.