ABA Medicaid rates in Hawaii put the technician hour above the national middle and caregiver training near the top: Hawaii Med-QUEST pays $70.64 an hour for code 97153, ranking 16th of 42 states and 11.3% above the national median of $63.44. The rate is $17.66 per 15-minute unit with modifier HN, effective 2025-01-01.
Hawaii's ABA program is defined by a single memo. Med-QUEST memo QI-2431 replaced the state's earlier guidelines on 2025-01-01, set every current ABA rate, and is recorded with a -21.7% change. All rates below are compiled from official Med-QUEST publications and link to their source documents on the Hawaii Medicaid rates hub.
QI-2431 and the 2025 reset of Hawaii ABA rates
Two memos frame ABA in Hawaii:
- Med-QUEST memo QI-2301 / FFS 23-01, effective 2023-01-13: "Coverage of IBT for children under 21 with ASD, Attachment C."
- Med-QUEST memo QI-2431 / FFS 24-13, effective 2025-01-01 and published 2024-12-31: "Guidelines for ABA, Attachment C," which replaces QI-2301 and carries the -21.7% change.
Every Hawaii ABA rate on file has the 2025-01-01 effective date, so the figures on this page are the post-QI-2431 schedule. For agencies that operated under the 2023 memo, budgets and payroll assumptions built on the earlier rates need to be rebuilt from these numbers. The state's program list names the "Hawaii Med-QUEST ABA / IBT fee-for-service rates (QI-2301, QI-2431 Attachment C)" as the source schedule.
Hawaii Medicaid ABA reimbursement by code
Hawaii uses modifiers to distinguish provider levels: HN on technician codes and HO on analyst codes.
| Code | Modifier | Per hour | Rank | vs national median |
|---|---|---|---|---|
| 97156 caregiver training | HO | $184.80 | 2 of 43 | +94.9% |
| 97155 analyst plan changes | HO | $143.76 | 9 of 41 | +42.3% |
| 97151 analyst assessment | HO | $114.08 | 23 of 41 | -2.1% |
| 97152 technician assessment support | HN | $80.96 | 13 of 29 | +5.1% |
| 97153 technician therapy | HN | $70.64 | 16 of 42 | +11.3% |
Caregiver training is the standout. Hawaii's $46.20 per 15 minutes is the highest rate in the country billed under 97156; only Rhode Island's $219.88, billed under T1027, ranks higher for caregiver training. For an agency, that makes structured parent and caregiver sessions one of the best-paid hours a BCBA can bill in Hawaii. Hawaii pays more for an hour of family training than for an hour of analyst treatment direction, a reversal of the usual order.
Assessment, by contrast, is slightly below the national median at $114.08, despite being an analyst-delivered code.
Group ABA paid per member
Hawaii pays its group codes per member rather than per session: $6.95 per 15 minutes for technician-led groups (97154, modifiers HM and UQ) and $13.74 per 15 minutes for analyst-led groups (97158, modifiers HO and UQ). Because the unit is defined per member, these rates are not ranked against the hourly figures other states publish. Agencies modeling group revenue should multiply by the number of members in each group.
Wages and margins on Hawaii ABA hours
Hawaii's technician wage runs below the national figure, while the analyst wage is close to it. The median wage for the closest comparable technician occupation was $20.39 an hour in May 2025, against $22.08 nationally; the analyst proxy was $28.89, against $28.53. Both are proxy occupations and understate pay for credentialed RBTs and BCBAs.
- 97153: wages take 41.0% of the rate, leaving $41.66 an hour after a loaded wage.
- 97152: wages take 35.8%, leaving $51.98.
- 97151: wages take 36.0%, leaving $73.02.
- 97155: wages take 28.6%, leaving $102.70.
- 97156: wages take 22.2%, leaving $143.74.
The analyst codes carry the margin in Hawaii. A practice whose treatment plans call for substantial caregiver training will see far better per-hour economics than one built on technician hours alone.
Prior authorization and 26-week authorizations
Hawaii's coverage rules are detailed. Each ABA code carries six or seven prior-authorization rules: six for 97151, 97152 and 97158, and seven for 97153, 97154, 97155 and 97156. Every code is limited to up to 26 weeks per authorization.
For operations, that means a reauthorization cycle at least every 26 weeks for each client, with clinical documentation prepared in advance. Agencies should calendar reauthorization deadlines at intake to avoid gaps in billable service.
Hawaii managed care: QUEST Integration plans negotiate
Hawaii has a dedicated managed-care rule for applied behavior analysis: "Plans negotiate; the published rate applies out of network." The programs on file include several QUEST Integration services. For ABA, each plan's contract sets the in-network rate, and the QI-2431 schedule governs out-of-network payment and anchors negotiations. Nine plans are on file; the Hawaii managed-care page lists them.
Hawaii compared with other states
On 97153, Hawaii's $70.64 is well short of Alaska ($127.80), Georgia ($123.64) and Iowa ($114.36), and comfortably above Louisiana ($40.00) and New York ($38.52). On caregiver training, only Rhode Island pays more. The national ABA rates hub compares every state per hour, and our methodology explains when a rate, such as Hawaii's per-member group rates, is left unranked.
Updated 2026-10-05