ABA Medicaid rates in Missouri are solidly above the median for technician therapy and exactly at it for analyst treatment: MO HealthNet pays $70.92 an hour for code 97153, ranking 15th of 42 states and 11.8% above the national median of $63.44. The rate is $17.73 per 15-minute unit, effective 2022-07-01.
Missouri also pays ABA outside managed care. Its managed-care rules include a line for applied behavior analysis, and the rule is that ABA is paid directly by the state. All rates below are compiled from official MO HealthNet publications and link to their source documents on the Missouri Medicaid rates hub.
| Code | Modifiers | Per hour | Rank | vs national median |
|---|---|---|---|---|
| 97153 technician therapy | none | $70.92 | 15 of 42 | +11.8% |
| 97155 analyst plan changes | none | $101.04 | 21 of 41 | 0.0% |
| 97151 analyst assessment | HO | $101.04 | 27 of 41 | -13.3% |
| 97156 caregiver training | HO | $80.52 | 34 of 43 | -15.1% |
| 97152 technician assessment support | HO, HM | $60.00 | 20 of 29 | -22.1% |
| 97154 technician-led group | HN, HM | $8.20 | 36 of 37 | -72.6% |
Analyst-led groups (97158, modifier HO) pay $3.16 a unit, or $12.64 an hour, ranking 27th of 30 and 66.1% below the national median of $37.30.
Most rates date to 2022-07-01. Caregiver training took effect 2025-07-01, and technician-led groups 2025-05-01.
Code 97153 is the technician's one-on-one treatment hour, and it fills most of every child's authorization. At 15th of 42 states and 11.8% above the median, MO HealthNet pays that hour comfortably. Combined with technician wages below the national level, the result is one of the better technician margins among mid-ranked states.
For an agency, the implication is straightforward: Missouri rewards programs built around individual technician therapy. The rate supports competitive pay and reasonable supervision, provided delivered hours stay close to authorized hours.
Delivery is where Missouri programs win or lose. A per-day unit maximum means hours missed on one day cannot be made up by a longer session on another, and every cancelled session leaves a technician's paid time unbilled. Clinic-based sessions, tight scheduling and quick backfilling of cancellations protect the margin more than any rate change would.
Missouri attaches modifiers to several ABA codes, and claims must carry them to price correctly. Technician therapy (97153) and analyst treatment (97155) carry none. Analyst assessment, caregiver training and analyst-led groups carry HO. Technician assessment support carries HO and HM, and technician-led groups carry HN and HM.
In practice, the modifier tells the payer who delivered the service. A claim with a missing or mismatched modifier can deny or price at the wrong rate, so billing systems should attach modifiers automatically based on the code and the credential of the staff member who delivered the session, rather than relying on manual entry.
Analyst treatment direction (97155) pays $25.26 per 15 minutes, or $101.04 an hour, landing exactly on the national median and 21st of 41 states. Analyst assessment (97151) pays the same hourly rate, but because assessment rates run higher nationally, it ranks 27th of 41 and 13.3% below the median.
Caregiver training (97156) pays $80.52 an hour, 34th of 43 and 15.1% below the median. Of the analyst codes, it is the weakest relative to other states. Technician assessment support (97152) pays $60.00 an hour, 20th of 29 and 22.1% below the median.
The pattern is a schedule that pays a fair price for ongoing analyst supervision but no premium for assessment or caregiver work. Agencies should model analyst revenue at a single blended rate rather than expecting assessment to subsidize treatment, as it does in some states.
Missouri's individual technician rate is comfortably above the median, and its analyst treatment rate lands precisely on the national median of $101.04. Group therapy is a different story. At $8.20 an hour, Missouri's technician-led group rate is one of the three lowest in the country, alongside North Dakota ($10.88) and Texas ($6.52). Analyst-led groups are also far below the median.
Group rates are paid per patient, but even with several participants, a Missouri technician-led group earns far less per staff hour than one-on-one therapy. For an agency, Missouri's schedule clearly favors individual services; groups make sense only where they are clinically necessary. Agencies that run large group programs in other states should not carry that model into Missouri without rebuilding the budget around individual hours.
Two items shape Missouri ABA:
- Rate Update for Applied Behavior Analysis (ABA) Services (MO HealthNet Bulletin Vol. 47-09), published 2024-07-12 with an effective date of 2024-07-01, recorded with a 13.54% change.
- Missouri SPA MO-25-0007, approved by CMS on 2026-03-09 and effective 2025-07-01, which adds Applied Behavior Analysis (ABA) and Transcranial Magnetic Stimulation (TMS) services to an existing comprehensive program in the Missouri state plan.
The SPA shares its effective date with the current caregiver-training rate. Agencies should confirm that the rates listed in the bulletin are the ones paying on their claims, since the effective dates attached to individual codes vary. When claims pay below the bulletin rate, the effective date on the code is the first thing to check.
Missouri's coverage rules are detailed. Every ABA code is limited per date of service, with MO HealthNet maximum units applying where CMS has no medically unlikely edit. The prior-authorization rule counts by code:
- 97152: 12 rules.
- 97153: 10 rules.
- 97155 and 97156: 8 rules each.
- 97158: 6 rules.
- 97151 and 97154: 5 rules each.
Daily maximums mean a long session can exceed the cap and leave units unpaid. Scheduling and billing systems should check each code's daily maximum before a session is booked.
The rule counts also signal administrative cost. With ten rules on the main treatment code, intake and authorization staff are a real line item in a Missouri budget. A tracker that shows each child's authorized units, expiry dates and pending renewals prevents the most common and most expensive problem: delivering hours after an authorization lapses.
Missouri's wages sit below national levels. The median wage for the closest comparable technician occupation was $20.09 an hour in May 2025, against $22.08 nationally; the analyst proxy was $27.36, against $28.53. Both are proxy occupations and understate pay for credentialed RBTs and BCBAs.
- 97153: wages take 40.3% of the $70.92 rate, leaving $42.37 an hour after a loaded wage.
- 97152: wages take 47.6% of the $60.00 rate, leaving $31.45.
- 97155 and 97151: wages take 38.5% of the $101.04 rate, leaving $62.15.
- 97156: wages take 48.3% of the $80.52 rate, leaving $41.63.
The technician margin is healthy for a mid-ranked state, helped by lower local wages. These margins come before travel, documentation, training and administration, so the working margin is smaller, but the structure supports paying above the local market to recruit credentialed staff.
Missouri's managed-care rules include a specific line for applied behavior analysis: "Paid directly by the state, outside managed care." The broader behavioral health line follows a different rule, under which plans must pay at least the published rate; the ABA-specific rule governs here. The programs include MO HealthNet fee-for-service and MO HealthNet Managed Care, with its General Plan and Show Me Healthy Kids Specialty Plan.
For ABA agencies, that means billing MO HealthNet directly at the fee schedule rather than negotiating with each plan. There is one rate per code, which simplifies forecasting, but no contract lever to win a premium. Four plans are on file; the Missouri managed-care page lists them and the rule for each service line.
On 97153, Missouri's $70.92 trails Alaska ($127.80), Georgia ($123.64) and Iowa ($114.36), and comfortably exceeds Louisiana ($40.00) and New York ($38.52).
Among its neighbors, Missouri's $17.73 per technician unit sits above Kansas ($16.25) and below Nebraska ($18.70) and Iowa ($28.59). Iowa pays its full technician rate for groups, the opposite of Missouri's approach, so the two states reward very different service models.
Start with individual hours. In Missouri, 97153 and 97155 carry the economics; groups, caregiver training and assessment are smaller lines. Estimate the technician-to-analyst hour ratio for a typical child and apply the rates above.
Then model delivered hours against the per-day maximums, and test the budget against a lower delivery rate. Include authorization staffing as a cost, since with up to 12 rules per code it is a real part of delivering every billed hour. When the state issues a new ABA bulletin, check the effective date code by code. The national ABA rates hub compares every state, and the Missouri hub covers all 68,416 current MO HealthNet rates, including the Missouri behavioral health rates many ABA agencies also bill.
Rates on this page are compiled from official MO HealthNet publications, including the MO HealthNet behavioral health fee schedule and Bulletin Vol. 47-09. Each rate in the full dataset links to its source document and effective date. Per-hour figures convert 15-minute unit rates to an hourly equivalent, and ranks compare only states that publish the same service. Our methodology explains the conversion and ranking rules.