ABA Medicaid rates in Washington are low on individual work and high on groups. Washington Apple Health pays $49.60 an hour for code 97153, one-on-one ABA delivered by a technician, 32nd of 42 states and 21.8% below the national median of $63.44. For analyst time on 97155 it pays $56.36 an hour, 40th of 41 states, and only Louisiana pays less. Yet Washington pays the same $49.60 an hour for group ABA, which puts it among the top ten states on both group codes.
All current Washington ABA rates took effect January 1, 2026. They are compiled from official Washington Apple Health publications, and each rate links to its source document.
Washington publishes 97153 at $12.40 per 15-minute unit with no modifier, or $49.60 an hour. That is above the lowest states, New York at $38.52 and Louisiana at $40.00, and far below Alaska at $127.80 and Georgia at $123.64.
Washington's wages make the rate tighter than its rank suggests. Federal data for May 2025 puts the state's median wage for the closest comparable technician occupation at $26.33 an hour, well above the national $22.08. That wage is 75.4% of the 97153 rate, leaving a margin of $12.18 an hour after a loaded wage. Supervision, travel, cancellations and administration all have to fit in that margin. An agency that pays technicians above the proxy wage to compete for staff will see that margin shrink further.
Washington appears on the national lists of lowest-paying states for both 97155 and 97151:
| Code | Service | Washington per hour | Rank | vs national median |
|---|---|---|---|---|
| 97155 | Treatment with plan changes by an analyst | $56.36 | 40 of 41 | -44.2% |
| 97151 | Assessment by an analyst | $75.16 | 39 of 41 | -35.5% |
| 97156 | Parent and caregiver training | $73.28 | 38 of 43 | -22.7% |
On 97155, only Louisiana at $27.00 pays less; Alabama at $60.00 pays slightly more. On 97151, only New Hampshire at $65.72 and Louisiana at $30.00 pay less. Caregiver training (97156) pays $18.32 per unit, also well below the national median of $94.80.
The striking feature is how close the analyst rate sits to the technician rate. In most states, a BCBA hour earns far more than a technician hour, reflecting the credential and the clinical responsibility. In Washington, 97155 pays only a few dollars an hour more than 97153, so the schedule gives little financial weight to the analyst's role.
The analyst margin is where Washington is most unusual. The state's analyst proxy wage is $33.13 an hour, against $28.53 nationally. After a loaded wage:
- 97155 analyst treatment: wage share 83.6%, margin $9.27 an hour.
- 97156 caregiver training: wage share 64.3%, margin $26.19 an hour.
- 97151 assessment: wage share 62.7%, margin $28.07 an hour.
- 97153 technician hour: wage share 75.4%, margin $12.18 an hour.
An hour of BCBA protocol-modification time earns a smaller margin than an hour of technician therapy. Both wage figures use proxy occupations and are floors; credentialed BCBAs often cost more, which would push the 97155 margin lower still.
What that does to supervision
When supervision is the least profitable hour on the schedule, agencies are pushed toward the minimum supervision a payer allows. That is the opposite of what a quality program usually wants. Washington agencies that keep strong supervision ratios tend to fund it from elsewhere: group programming, efficient scheduling and, where possible, commercial contracts.
Assessment and parent training
Assessments on 97151 and caregiver training on 97156 carry better margins than 97155, even though both rank near the bottom nationally. For a BCBA's week, that means assessment and parent sessions are the more sustainable analyst work, and protocol modification is the time to schedule most carefully.
Recruiting in a high-wage state
Washington's proxy wages sit above the national figures at both levels, $26.33 for technicians and $33.13 for analysts. That is the other half of the margin problem. In a lower-wage state, a rate in the bottom third can still leave room; in Washington it does not, because the same rate has to cover a more expensive workforce. Agencies competing for credentialed staff against schools, hospitals and commercial ABA programs often have to pay above the proxy wage, so a realistic Washington budget starts from the agency's actual pay scale rather than the median, and tests whether each code still covers its cost at that scale.
Washington pays both group codes at $12.40 per unit with modifier UN, or $49.60 an hour, the same hourly figure as individual technician therapy.
- Technician-led groups (97154): 8th of 37 states, 65.6% above the national median of $29.96.
- Analyst-led groups (97158): 9th of 30 states, 33.0% above the national median of $37.30.
Because the group rate is per patient, a group session can bring in more per staff hour than an individual session. That makes group programming the most attractive way for a Washington agency to improve margins, where it fits each client's treatment plan. Social-skills groups, school-readiness groups and sibling or peer programs are the usual formats.
Every Washington ABA code is billed in 15-minute units; the hourly figures here are four units. The individual codes, 97151, 97153, 97155 and 97156, carry no modifier. The group codes 97154 and 97158 are billed with modifier UN on the current schedule.
Because the group and individual technician rates are identical per hour, the billing difference between a group and an individual session is the number of participants, not the rate. Accurate attendance records for each group session are therefore the core of group billing.
Washington's authorization rules mirror its rate structure. The group codes, 97154 and 97158, each carry six prior authorization rules on the schedule, the most of any ABA code. Code 97153 carries one, and 97151, 97155 and 97156 carry none. No ABA code has a published unit limit.
For intake teams, the practical effect is that group services, the best-paid line relative to the national median, also require the most authorization work. An agency planning to grow group programming should build the authorization workflow first: clear clinical criteria for which clients benefit from groups, goals that a group setting can address, and documentation that ties attendance to progress.
Washington pays Medicaid through Washington Apple Health fee-for-service and through managed care. For ABA, the state's rule is that plans must pay at least the published rate. That makes the Apple Health schedule the floor for every in-network ABA payment. Our data counts 51 plans and arrangements in the state. See Washington managed care rules.
The rule differs from Washington's broader behavioral health line, where plans negotiate and the published rate applies out of network. For ABA agencies, the floor is protective, but at these rate levels it also means the floor is low. Contract talks with Apple Health plans are about how far above the floor a plan will go. Given how thin the analyst margin is at $56.36 an hour, BCBA rates are the line most worth raising, and group rates are the line most worth protecting.
All Washington ABA codes carry a January 1, 2026 effective date, so the schedule moved as a block. For an agency, that makes the calendar year the natural budget period. Two planning habits follow.
First, build budgets on the published rates and treat any plan premium above the floor as contract-specific, not state-wide. Second, watch labor costs closely. With wage shares of 75.4% on technician time and 83.6% on analyst treatment, a modest wage increase can erase most of the margin on an hour, so wage decisions should be modeled against the per-hour rates before they are made.
Washington is a low-rate state for individual ABA and a high-rate state for groups. Neighboring Oregon is another state worth comparing for agencies working across the border, and Alaska ABA rates lead the country on technician time. Nationally, Vermont leads on 97155 at $197.40 and New Mexico on 97151 at $450.60, while Virginia leads on analyst-led groups at $112.52. At the bottom, Louisiana is the only state paying less than Washington for BCBA treatment.
- Model margins per hour, not per code. High local wages mean the rate alone says little; the wage share is what decides viability.
- Build group programs deliberately. Groups are Washington's strongest line, but they carry the heaviest authorization rules.
- Negotiate analyst rates first. The floor protects against underpayment, but BCBA time needs a premium above it.
- Budget on the calendar year. The January 1 effective date makes January the annual pricing event.
- Track cancellations closely. With margins this thin, a few unbilled hours a week can decide whether a caseload breaks even.
All 42,408 current Washington Medicaid rates are available with a subscription; see pricing.
Rates are compiled from official Washington Apple Health publications, including the fee-for-service ABA schedule, and each rate links to its source document. Rates published per 15-minute unit are converted to hourly figures by multiplying by four, and rankings compare the same service at the same provider level across states. Wages use federal occupational data for May 2025. For the full ranking, see ABA Medicaid rates by state; for every Washington code, the Washington Medicaid rates hub; and for unit conversion, our methodology.