What is the Difference between Billing Codes 97153 and 97151?
In ABA therapy, the primary difference between codes 97153 and 97151 lies in the type of service provided and the professional responsible for delivering it:
- CPT Code 97153 is the “workhorse” code for direct, one-on-one therapy. It involves a Registered Behavior Technician (RBT) implementing a behavior protocol with a client under the supervision of a Board Certified Behavior Analyst (BCBA). It is billed in 15-minute units (1–8 units per session), with typical reimbursement rates ranging from $35 to $75 per unit.
- CPT Code 97151 is used for assessment and plan development. This service is performed by the BCBA only and includes initial evaluations, periodic reassessments, and the creation of the plan of care. It is billed in 15-minute units (1–4 units per session), with higher typical rates ranging from $90 to $175 per unit.
While 97151 defines the starting point and therapeutic goals, 97153 covers the day-to-day treatment hours used to move the child forward toward those goals.
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