ABA Medicaid rates in Delaware put the technician hour almost exactly at the national middle: Delaware Medicaid pays $62.72 an hour for code 97153, ranking 22nd of 42 states and just 1.1% below the national median of $63.44. The rate is $15.68 per 15-minute unit, effective 2024-01-01.
The rest of Delaware's ABA schedule is far less typical. Its assessment rate ranks 4th in the country, its caregiver-training rate ranks 8th, and its analyst treatment rate ranks 37th. All rates are compiled from official Delaware Medicaid publications (DMMA / DMAP) and link to their source documents on the Delaware Medicaid rates hub.
| Code | Per 15 min | Per hour | Rank | vs national median |
|---|---|---|---|---|
| 97151 analyst assessment (HO) | $43.76 | $175.04 | 4 of 41 | +50.2% |
| 97156 caregiver training | $31.25 | $125.00 | 8 of 43 | +31.9% |
| 97155 analyst plan changes | $17.66 | $70.64 | 37 of 41 | -30.1% |
| 97153 technician therapy | $15.68 | $62.72 | 22 of 42 | -1.1% |
Three of the four rates took effect 2024-01-01. The assessment rate, billed with modifier HO, dates to 2022-11-01.
For the 97153 Delaware Medicaid rate, the takeaway is predictability. At $62.72, a technician hour pays almost exactly what the typical state pays, so an agency's national staffing and pricing assumptions for direct therapy carry over to Delaware with little adjustment. The analyst codes are where the planning work lies.
Every Delaware ABA code is priced per 15-minute unit, so the hourly figures here are four units. Revenue follows documented minutes, which makes accurate start and stop times the simplest revenue control an agency has. Late starts, early endings and same-day cancellations all cost units directly.
The assessment rate is published with modifier HO. A modifier is a two-character suffix that tells the payer something about the service or the provider; HO is commonly associated with services delivered by a master's-level clinician. Billing systems should attach it to every 97151 claim line, because a line without the expected modifier may not price at the published rate. The treatment codes are published without a modifier.
All three analyst-delivered codes in Delaware are performed by the same professional, but they pay very differently per hour:
- Assessment (97151): $175.04, 4th of 41. Delaware is among the national leaders on this code, alongside New Mexico ($450.60), Vermont ($263.20), Minnesota ($200.44) and Kansas ($175.00).
- Caregiver training (97156): $125.00, 8th of 43, well above the national median of $94.80.
- Protocol modification (97155): $70.64, 37th of 41, well below the national median of $101.04.
For a BCBA's calendar, the implication is direct. In most states the analyst's treatment hour is the anchor of supervision revenue. In Delaware, an hour spent directing treatment with the client pays $70.64, while an hour of family training pays $125.00 and an hour of assessment $175.04. Practices that build structured caregiver training into treatment plans, and keep reassessments current, will earn noticeably more per analyst hour than those that rely on 97155 for most BCBA time.
Keeping clinical and financial priorities aligned
None of this means analysts should cut protocol modification where a client needs it. The point is to make sure every billable activity is captured. Family-training sessions that happen informally during treatment, or reassessments that slide past their due date, are where Delaware agencies most often leave the best-paying analyst time unbilled.
Delaware's wage data sits below national levels for both roles. The median wage for the closest comparable technician occupation was $19.57 an hour in May 2025, against $22.08 nationally. The analyst proxy was $26.93, against $28.53. Both are proxy occupations and understate pay for credentialed RBTs and BCBAs.
Applied to the Delaware rates:
- 97153: wages take 44.3% of the $62.72 rate, leaving $34.91 an hour after a loaded wage.
- 97155: wages take 54.2% of the $70.64 rate, leaving $32.36.
- 97156: wages take 30.6% of the $125.00 rate, leaving $86.72.
- 97151: wages take 21.9% of the $175.04 rate, leaving $136.76.
The 97155 margin is the pressure point. Even at the proxy wage, an hour of analyst treatment leaves less margin than an hour of technician therapy. With BCBA pay typically above the proxy, supervision-heavy cases can run at a loss on the 97155 portion unless assessment and caregiver-training hours balance them.
Delaware publishes no group ABA rate. Nationally, technician-led group therapy has a median of $29.96 an hour across 40 states, and analyst-led groups a median of $37.30 across 33 states. Without a Delaware rate, group social-skills programming has no published fee-schedule rate to bill against. Agencies planning group services should confirm with the state how, or whether, they are reimbursed before building them into a clinic schedule or a budget.
Delaware's programs include Delaware Medicaid fee-for-service (DMMA / DMAP), the Diamond State Health Plan (DSHP) managed care program, DSHP Plus for managed long-term services and supports, the DDDS Lifespan waiver, and the PROMISE behavioral health home- and community-based services program run by DSAMH.
For applied behavior analysis specifically, Delaware's managed-care rule is "Plans negotiate; the published rate applies out of network." That differs from the state's general behavioral health line, which is paid directly by the state, outside managed care. For an ABA agency, it means each DSHP plan, including AmeriHealth Caritas Delaware, Delaware First Health and Highmark Health Options, sets its own in-network ABA rate by contract, and the DMAP fee schedule is the out-of-network reference. Five plans are on file; the Delaware managed-care page lists them and the rule for each service line.
Negotiating with DSHP plans
Because the DMAP schedule is what a plan pays out of network, it is the natural anchor for contract talks. Delaware's unusual rate shape adds a wrinkle: a contract that pays a flat percentage of the DMAP schedule preserves the strong assessment and caregiver-training rates, while one that pays a single blended hourly rate can erase them. Agencies should read the code list and rate basis in each contract carefully.
Delaware uses state directed payments heavily inside managed care. CMS approved a renewal of the state's HCBS directed payment for 2026 with a 5.0% figure, along with renewals for hospital and behavioral health providers and nursing facilities. None of these is specific to ABA, but they show that Delaware channels rate increases through plans for some service lines.
On the fee-for-service side, the DMAP 2026 Physician Fee Schedule took effect 2026-01-01 with a -0.64% change, while the ASC and dental schedules rose. The ABA rates on this page did not move with that edition: three still carry 2024-01-01 and the assessment rate 2022-11-01. Agencies should check each new physician schedule edition for ABA updates rather than assume the schedule-wide change applies.
ABA is a small slice of Delaware Medicaid, whose schedule is dominated by hospital outpatient and physician services. The ABA codes sit in the general DMAP physician schedule rather than a separate autism schedule, which is why they are updated with physician schedule editions and why their effective dates can lag behind those editions when the state leaves them unchanged.
For agencies that also deliver adjacent services, Delaware's structure matters. Behavioral health services under the PROMISE program and developmental disability services under the DDDS Lifespan waiver are paid directly by the state, while ABA in managed care follows plan contracts. A family whose child receives ABA through a DSHP plan and other supports through a waiver will see two payment routes, and an agency serving both sides needs billing staff who know each one. The Delaware Medicaid rates hub summarizes those service lines and their rules.
On 97153, Delaware's $62.72 sits in the middle of a very wide range. Alaska pays $127.80, Georgia $123.64 and the District of Columbia $110.00, while Louisiana pays $40.00 and New York $38.52. For a Mid-Atlantic operator, Delaware pays less per technician hour than nearby DC but rewards assessment and family training more than most states. Maryland and New Jersey are the other regional comparisons.
- Budget analyst time by activity. Separate assessment, family training and protocol modification hours; their rates differ by more than double.
- Protect the technician hour. At the national median, 97153 revenue depends on scheduling density and low cancellation rates rather than on rate advantage.
- Negotiate code by code. In DSHP contracts, insist on rates that preserve the 97151 and 97156 premiums.
- Use the 97155 gap in advocacy. At 30.1% below the median, analyst treatment is the clearest case for a rate review.
- Plan before launching groups. With no published group rates, group programs should be costed as unreimbursed until a billing route is confirmed.
Rates on this page are compiled from official Delaware Medicaid publications, including the DMAP 2026 Physician Fee Schedule and earlier DMAP physician schedules. Each rate in our dataset links to its source document, and hourly figures are the 15-minute unit rate multiplied to an hour. All 46,693 current Delaware Medicaid rates, with history back to 2008, are available on our plans. The national ABA rates hub shows every state per hour, and our methodology explains the conversion and ranking.