ABA Medicaid rates in the District of Columbia are among the highest in the country, and they have not moved in years: DC Medicaid pays $110.00 an hour for code 97153 billed with modifier TL, ranking 4th of 42 states and 73.4% above the national median of $63.44. The rate is $27.50 per 15-minute unit and has been in effect since 2019-01-01.
That combination, a top-five rate on a schedule dating to 2019, is what sets DC apart. All rates below are compiled from official DC Medicaid publications from the Department of Health Care Finance (DHCF) and link to their source documents on the District of Columbia Medicaid rates hub.
DC publishes four ABA rates, three of them with the TL modifier.
| Code | Modifier | Per 15 min | Per hour | Rank | vs national median | Effective |
|---|---|---|---|---|---|---|
| 97153 technician therapy | TL | $27.50 | $110.00 | 4 of 42 | +73.4% | 2019-01-01 |
| 97155 analyst plan changes | TL | $31.25 | $125.00 | 14 of 41 | +23.7% | 2019-01-01 |
| 97154 technician-led group | TL | $18.43 | $73.72 | 3 of 37 | +146.1% | 2021-01-01 |
| T1027 caregiver training | GP | $18.43 | not ranked | n/a | n/a | 2015-10-19 |
DC publishes no rate for analyst assessment (97151), caregiver training under 97156, or analyst-led groups (97158).
The three ABA treatment codes are priced per 15-minute unit and published with modifier TL. A modifier is a two-character suffix that tells the payer something specific about the service; in DC, it is part of what identifies the ABA rate on the schedule. Billing systems should attach TL to every 97153, 97154 and 97155 line and GP to T1027, because a line without the expected modifier may not price at the published rate or may deny.
Because the treatment codes are unit-based, revenue follows documented minutes. Recording actual start and stop times protects revenue that late starts and early endings would otherwise erode. With a technician unit worth $27.50, a single lost unit per session across a caseload adds up quickly over a month.
DC's rates favor direct therapy over analyst time. The technician rate is 73.4% above its national median, but the analyst rate for 97155 is only 23.7% above its median. The result is a narrow ladder: $110.00 for the technician hour against $125.00 for the analyst hour.
For an agency, that tilts the economics toward technician-delivered hours. Supervision is still paid well in absolute terms, but each additional BCBA hour adds less revenue relative to a technician hour than it would in most states. Service models with lean but compliant supervision ratios fit the DC schedule best.
The assessment question
With no published 97151 rate, the analyst's initial and periodic assessments have no DC rate to bill against on this schedule. Agencies should confirm with DHCF how assessment and treatment-planning time is reimbursed before building intake capacity, because assessment work is a significant share of a BCBA's time early in each case.
DC's technician-led group rate of $73.72 an hour is 146.1% above the national median of $29.96 and ranks 3rd of 37 states, behind only Georgia ($123.64) and Iowa ($114.36), which pay their full individual rate for groups. Because group rates are paid per patient, a well-run group session in DC can produce strong revenue per staff hour. Groups also arrived later than the individual codes, with a 2021-01-01 effective date.
For a clinic-based agency, groups are worth serious consideration in DC. Social-skills and school-readiness groups led by a technician, under analyst direction, can serve clients whose plans call for peer interaction while using staff time efficiently. Each participant's authorization and treatment plan should name group services explicitly so the hours are billable. Attendance matters as much as the rate: because groups are paid per participant, a session that runs with several absences earns far less than the schedule implies, so reminder calls and a waiting list for open seats protect group revenue.
DC bills its caregiver-training service under HCPCS code T1027 with modifier GP, at $18.43, effective 2015-10-19. The unit for that rate is not published on an hourly basis, so it is not ranked against the 97156 rates other states use. Nationally, caregiver training has a median of $94.80 an hour, and Rhode Island also pays under T1027. Agencies should confirm the billing unit for T1027 directly in the DC fee schedule before modeling family-training revenue.
DC's technician wage sits well above the national figure. The median wage for the closest comparable technician occupation was $28.59 an hour in May 2025, against $22.08 nationally. The analyst proxy was $29.06, close to the national $28.53. Both are proxy occupations and understate pay for credentialed RBTs and BCBAs.
- 97153: wages take 36.9% of the $110.00 rate, leaving $69.37 an hour after a loaded wage.
- 97155: wages take 33.0% of the $125.00 rate, leaving $83.70.
Even with high local wages, DC's rates leave substantial margin per hour. The risk is time: a rate frozen since 2019 does not move with wages, so each year that passes without an update narrows that margin.
Planning for a frozen rate
A rate that has not changed since 2019 should be budgeted as flat. Agencies that commit to annual raises for technicians, which a competitive DC labor market often requires, should model how many years of raises the current margin can absorb. That exercise is more useful than any single-year margin figure, because it shows when the DC schedule stops covering the wage path an agency has promised.
No prior-authorization rule or unit limit appears at the code level for 97153, 97154, 97155 or T1027. That does not mean services are unmanaged; medical-necessity documentation still applies, and records must support every billed unit on review.
The practical consequence is that DC's billing risk sits in documentation audits rather than front-end denials. Treatment plans should state recommended hours by code, session notes should tie each unit to a plan goal, and supervision notes should show the analyst's involvement in each case.
DC's programs include DC Medicaid (DHCF) fee-for-service and the Intellectual and Developmental Disabilities and Individual and Family Support waivers run by the Department on Disability Services. DC classifies behavioral health as "Paid directly by the state, outside managed care." For ABA, that means the DHCF fee schedule is the rate agencies receive, without plan-by-plan negotiation. Six plans are on file, including AmeriHealth Caritas District of Columbia, MedStar Family Choice DC and Health Services for Children with Special Needs; the DC managed-care page shows the rule for each service line.
Enrollment shifts still matter even though the rate does not change by plan. Transmittal 26-19 moved Wellpoint DC enrollees to AmeriHealth Caritas DC effective August 1, 2026, so agencies should confirm each client's current plan assignment when verifying eligibility.
DHCF has been active in 2026, though not on ABA. Transmittal 26-14 updated Medicaid fee schedule reimbursement rates effective July 1, 2026, alongside rate notices for home health aides, PCA services and assisted living, and Transmittal 26-21 introduced new IDD waiver service rates effective August 1, 2026. Hospital payment updates followed on October 1, 2026.
For ABA agencies, the lesson is to read each transmittal. DC's ABA rates have stayed put through several rounds of updates, but when they do change, a DHCF transmittal is where the change will appear.
DC's $110.00 places it in a short group of states paying $110.00 or more an hour on 97153: Alaska at $127.80, Georgia at $123.64 and Iowa at $114.36, with Virginia fifth at $93.92. At the other end, Louisiana pays $40.00 and New York $38.52. For a Mid-Atlantic operator, DC's technician and group rates are a clear draw, while its analyst rate is closer to the pack; Maryland is the other nearby comparison.
- Budget the rate as flat. With core rates unchanged since 2019-01-01, multi-year budgets should not assume an increase.
- Lead with technician hours and groups. The 97153 and 97154 rates carry DC's biggest premiums over the national median, so service growth in those codes moves revenue most.
- Keep supervision lean but compliant. The step from $110.00 to $125.00 means extra analyst hours add relatively little revenue.
- Settle assessment billing up front. Without a published 97151 rate, confirm how intake assessments are paid before scaling intake.
- Verify plan assignment monthly. Plan exits and auto-assignments do not change the rate, but they can delay claims if eligibility records are stale.
Rates on this page are compiled from official DC Medicaid publications, including the DHCF Medical Fee Schedule Report and the Provider Type fee schedule reports from the DC Medicaid MMIS. Each rate in our dataset links to its source document, and hourly figures are the 15-minute unit rate multiplied to an hour; rates published without an hourly unit, such as T1027, are left unranked. All 87,654 current DC Medicaid rates are available on our plans. The national ABA rates hub compares every state per hour, and our methodology explains how units are converted.