ABA Medicaid Reimbursement Dashboard
Applied Behavior Analysis — Mid-Atlantic States Coverage & Qualification Reference
5
States
21
Roles
47
Service Codes
38
Pathways
Click a state on the map to view its provider roles and top-line reimbursement rates. Toggle the regulatory overlay to compare which states require state-issued licenses versus deferring to BACB credentials.
Washington, DC Maryland Pennsylvania Virginia West Virginia DC MD PA VA WV
Washington, DC
Maryland
Pennsylvania
Virginia
West Virginia
State-regulated
BACB-deferred
Hybrid
Select a state on the map to view details
Medicaid fee schedule rates for ABA services by CPT code, provider tier, and state. All rates are per 15-minute unit unless otherwise noted.
StateCPTModifierServiceProvider TierRateUnitDaily MaxSourceEffective
DC97151Behavior Identification AssessmentAllN/A15 min32 UnitsDC Interactive Fee Schedule2019-01-01
DC97152Behavior ID Supporting AssessmentAllN/A15 min1 UnitsDC Interactive Fee Schedule2019-01-01
DC97153TL, 93Adaptive Behavior Treatment by ProtocolAll$27.5015 min32 UnitsDC Interactive Fee Schedule2023-03-21
DC97154TL, 93Group Adaptive Behavior Treatment by ProtocolAll$18.4315 min18 unitsDC Interactive Fee Schedule2023-03-01
DC97155TL, 93Adaptive Behavior Treatment with Protocol ModificationAll$31.2515 min24 unitsDC Interactive Fee Schedule2023-03-01
DC97156Family Guidance (child present)AllN/A15 min16 unitsDC Interactive Fee Schedule2019-01-01
MD97151-Behavior Identification AssessmentBCBA-D-level$38.3415 min32 unitsMD ABA Manual2024-07-01
MD97151-Behavior Identification AssessmentBCBA-level$38.3415 min32 unitsMD ABA Manual2024-07-01
MD97152-Behavior ID Supporting AssessmentBCaBA-level$19.1715 min32 unitsMD ABA Manual2024-07-01
MD97152-Behavior ID Supporting AssessmentTechnician$19.1715 min32 unitsMD ABA Manual2024-07-01
MD97153-Adaptive Behavior Treatment by ProtocolBCBA-D-level$24.4115 min32 unitsMD ABA Manual2024-07-01
MD97153-Adaptive Behavior Treatment by ProtocolBCBA-level$24.4115 min32 unitsMD ABA Manual2024-07-01
MD97153-Adaptive Behavior Treatment by ProtocolBCaBA-level$20.9115 min32 unitsMD ABA Manual2024-07-01
MD97153-Adaptive Behavior Treatment by ProtocolBCaBA-level$20.9115 min32 unitsMD ABA Manual2024-07-01
MD97153-Adaptive Behavior Treatment by ProtocolTechnician$19.1715 min32 unitsMD ABA Manual2024-07-01
MD97154Group Adaptive Behavior Treatment by ProtocolBCBA-D-level$10.4515 min16 unitsMD ABA Manual2024-07-01
MD97154Group Adaptive Behavior Treatment by ProtocolBCBA-level$10.4515 min16 unitsMD ABA Manual2024-07-01
MD97154Group Adaptive Behavior Treatment by ProtocolBCaBA-level$8.3615 min16 unitsMD ABA Manual2024-07-01
MD97154Group Adaptive Behavior Treatment by ProtocolTechnician$6.9615 min16 unitsMD ABA Manual2024-07-01
MD97155-Adaptive Behavior Treatment with Protocol ModificationBCBA-D-level$38.3415 min24 unitsMD ABA Manual2024-07-01
MD97155-Adaptive Behavior Treatment with Protocol ModificationBCBA-level$38.3415 min24 unitsMD ABA Manual2024-07-01
MD97155GTRemote Direction of TechnicianBCBA-level$38.3415 min24 unitsMD ABA Manual2024-07-01
MD97156-Family Guidance (child absent)BCBA-D-level$20.9115 min16 unitsMD ABA Manual2024-07-01
MD97156U2Family Guidance (child present)BCBA-D-level$38.3415 min16 unitsMD ABA Manual2024-07-01
MD97156-Family Guidance (child absent)BCBA-level$20.9115 min16 unitsMD ABA Manual2024-07-01
MD97156U2Family Guidance (child present)BCBA-level$38.3415 min16 unitsMD ABA Manual2024-07-01
MD97156-Family Guidance (child absent)BCaBA-level$12.2115 min16 unitsMD ABA Manual2024-07-01
MD97156U2Family Guidance (child present)BCaBA-level$20.9115 min16 unitsMD ABA Manual2024-07-01
VA97151HNBehavior Identification AssessmentLABA-level$23.4815 minProject Bravo Service Rates2021-12-01
VA97151HOBehavior Identification AssessmentLBA-level$46.6315 minProject Bravo Service Rates2021-12-01
VA97151TFBehavior Identification AssessmentLMHP-level$39.4015 minProject Bravo Service Rates2021-12-01
VA97152HNBehavior ID Supporting AssessmentLABA-level$23.4815 minProject Bravo Service Rates2021-12-01
VA97152Behavior ID Supporting Assessment$15.0015 minProject Bravo Service Rates2021-12-01
VA97153HNAdaptive Behavior Treatment by ProtocolLABA-level$23.4815 minProject Bravo Service Rates2021-12-01
VA97153HOAdaptive Behavior Treatment by ProtocolLBA-level$46.6315 minProject Bravo Service Rates2021-12-01
VA97153TFAdaptive Behavior Treatment by ProtocolLMHP-level$39.4015 minProject Bravo Service Rates2021-12-01
VA97153Adaptive Behavior Treatment by Protocol$15.0015 minProject Bravo Service Rates2021-12-01
VA97154HNGroup Adaptive Behavior Treatment by ProtocolLABA-level$15.6015 minProject Bravo Service Rates2021-12-01
VA97154HOGroup Adaptive Behavior Treatment by ProtocolLBA-level$15.5515 minProject Bravo Service Rates2021-12-01
VA97154TFGroup Adaptive Behavior Treatment by ProtocolLMHP-level$13.1315 minProject Bravo Service Rates2021-12-01
VA97154Group Adaptive Behavior Treatment by Protocol$12.7715 minProject Bravo Service Rates2021-12-01
VA97155HNAdaptive Behavior Treatment with Protocol ModificationLABA-level$23.4815 minProject Bravo Service Rates2021-12-01
VA97155HOAdaptive Behavior Treatment with Protocol ModificationLBA-level$46.6315 minProject Bravo Service Rates2021-12-01
VA97155TFAdaptive Behavior Treatment with Protocol ModificationLMHP-level$39.4015 minProject Bravo Service Rates2021-12-01
VA97156HNFamily Guidance (child absent)LABA-level$23.4815 minProject Bravo Service Rates2021-12-01
VA97156HOFamily Guidance (child absent)LBA-level$46.6315 minProject Bravo Service Rates2021-12-01
VA97156TFFamily Guidance (child absent)LMHP-level$39.4015 minProject Bravo Service Rates2021-12-01
Provider qualification requirements by state and role. Each role may have multiple qualification pathways (OR logic) — within each pathway, all listed requirements must be met (AND logic).
Washington, DC
3 roles
Licensed Behavior Analyst
BCBA-level
Can billCan supervise
BCaBA
BCaBA-level
Cannot billCannot supervise
RBT
Technician
Cannot billCannot supervise
Licensed Behavior Analyst — 1 qualification pathway
Standard
BACB cert + master's + DC license
Effective: 2024-07-19
BCaBA — 1 qualification pathway
BACB Only
Current BCaBA (no state license)
Effective: 2024-07-19
RBT — 1 qualification pathway
BACB Only
Current RBT (no state license)
Effective: 2024-07-19
Maryland
5 roles
Licensed Psychologist
Psychologist
Can billCan supervise
LBA (BCBA/BCBA-D)
BCBA-level
Can billCan supervise
BCaBA
BCaBA-level
Cannot billCannot supervise
RBT
Technician
Cannot billCannot supervise
BT
Technician
Cannot billCannot supervise
Licensed Psychologist — 1 qualification pathway
Standard
Licensed psychologist pathway
  • licenseMust hold Maryland psychologist license
    COMAR 10.09.28.02(E)
  • scopeMust act within scope of practice
    COMAR 10.09.28.02(E)
Effective: 2022-07-01
LBA (BCBA/BCBA-D) — 1 qualification pathway
Standard
BCBA/BCBA-D with state license
  • licenseMust hold Maryland LBA license
    COMAR 10.09.28.02(F-G)
  • credentialMust have current BACB certification
    COMAR 10.09.28.02(F-G)
Effective: 2022-07-01
BCaBA — 1 qualification pathway
Standard
BCaBA with supervision
  • credentialMust have current BCaBA certification
    COMAR 10.09.28.02(H)
  • supervisionMust work under LBA or psychologist
    COMAR 10.09.28.02(H)
  • documentationSupervision must be documented in writing
    COMAR 10.09.28.02(H)
Effective: 2022-07-01
RBT — 1 qualification pathway
Standard
RBT with supervision
  • ageMust be at least 18 years old
    COMAR 10.09.28.02(I)
  • credentialMust be registered with BACB as RBT
    COMAR 10.09.28.02(I)
  • educationMust have HS diploma or GED
    COMAR 10.09.28.02(I)
  • supervisionMust work under LBA or psychologist
    COMAR 10.09.28.02(I)
  • documentationSupervision must be documented in writing
    COMAR 10.09.28.02(I)
Effective: 2022-07-01
BT — 1 qualification pathway
Standard
BT with 90-day registration requirement
  • ageMust be at least 18 years old
    COMAR 10.09.28.02(J)
  • credentialMust register with BACB within 90 days
    COMAR 10.09.28.02(J)
  • educationMust have HS diploma or GED
    COMAR 10.09.28.02(J)
  • supervisionMust work under LBA or psychologist
    COMAR 10.09.28.02(J)
  • documentationSupervision must be documented in writing
    COMAR 10.09.28.02(J)
Effective: 2022-07-01
Pennsylvania
6 roles
Administrative Director
Admin
Cannot billCannot supervise
Clinical Director
Director
Cannot billCan supervise
Behavior Analytic Services
BCBA-level
Can billCan supervise
Behavior Consultation-ABA
BCaBA-level
Can billCan supervise
Assistant Behavior Consultation-ABA
Assistant
Cannot billCannot supervise
BHT-ABA
Technician
Cannot billCannot supervise
Administrative Director — 2 qualification pathways
Bachelor's Degree
Bachelor's in qualifying field
  • educationBachelor's degree in qualifying field
    § 5240.81(a)(1)
  • accreditationFrom accredited institution
    § 5240.81(a)(1)
Effective: 2019-10-19
Clinical Director Quals
Meets clinical director requirements
  • qualificationSame quals as clinical director
    § 5240.81(a)(2)
Effective: 2019-10-19
Clinical Director — 3 qualification pathways
Licensed + BCBA + Experience
Licensed professional with BCBA and 2 years experience
  • licenseLicensed in Pennsylvania
    § 5240.81(c)(1)
  • credentialBCBA or equivalent certification
    § 5240.81(c)(1)
  • experience2 years ABA experience
    § 5240.81(c)(1)
Effective: 2022-07-01
Psychologist + 5yr Experience
Licensed psychologist with 5 years ABA oversight + 40hr training
  • licenseLicensed psychologist in PA
    § 5240.81(c)(2)
  • experience5 years overseeing ABA program
    § 5240.81(c)(2)
  • training40 hours ABA training
    § 5240.81(c)(2)
Effective: 2022-07-01
Psychologist + ABA Degree
Licensed psychologist with graduate ABA degree/certificate
  • licenseLicensed psychologist in PA
    § 5240.81(c)(3)
  • educationGraduate ABA degree/certificate
    § 5240.81(c)(3)
Effective: 2022-07-01
Behavior Analytic Services — 1 qualification pathway
Licensed + BCBA
Licensed professional with BCBA certification
  • licenseLicensed in Pennsylvania
    § 5240.81(d)
  • credentialBCBA or equivalent certification
    § 5240.81(d)
  • ongoing training16 hours annual training
    § 5240.83(b)
Effective: 2019-10-19
Behavior Consultation-ABA — 4 qualification pathways
Licensed + BCaBA
Licensed professional with BCaBA or equivalent
  • licenseLicensed in Pennsylvania
    § 5240.81(e)(1)
  • credentialBCaBA or equivalent certification
    § 5240.81(e)(1)(i)
  • ongoing training16 hours annual training
    § 5240.83(b)
Effective: 2019-10-19
Licensed + Experience + Credits
Licensed with 1yr experience + 12 ABA credits
  • licenseLicensed in Pennsylvania
    § 5240.81(e)(1)
  • experience1 year ABA experience
    § 5240.81(e)(1)(ii)
  • education12 college credits in ABA
    § 5240.81(e)(1)(ii)
Effective: 2019-10-19
Licensed + Supervised Experience
Licensed with 1yr supervised experience + 40hr training
  • licenseLicensed in Pennsylvania
    § 5240.81(e)(1)
  • experience1 year supervised ABA experience
    § 5240.81(e)(1)(iii)
  • training40 hours ABA training
    § 5240.81(e)(1)(iii)
Effective: 2019-10-19
Psychologist + Experience
Licensed psychologist with 1yr experience + 40hr training
  • licenseLicensed psychologist in PA
    § 5240.81(e)(2)
  • experience1 year ABA experience
    § 5240.81(e)(2)
  • training40 hours ABA training
    § 5240.81(e)(2)
Effective: 2019-10-19
Assistant Behavior Consultation-ABA — 3 qualification pathways
Behavior Specialist Quals
Meets behavior specialist licensure quals (minus experience)
  • qualificationBehavior specialist quals minus experience
    § 5240.81(f)(1)
Effective: 2019-10-19
BCaBA + Bachelor's
BCaBA certification + bachelor's in qualifying field
  • credentialBCaBA or equivalent certification
    § 5240.81(f)(2)
  • educationBachelor's in qualifying field
    § 5240.81(f)(2)
  • initial training20 hours initial training
    § 5240.83(c)(1)
  • ongoing training20 hours annual training
    § 5240.83(c)(2)
Effective: 2019-10-19
Experience + Bachelor's + Credits
6 months experience + bachelor's + 12 ABA credits
  • experience6 months ABA experience
    § 5240.81(f)(3)
  • educationBachelor's in qualifying field
    § 5240.81(f)(3)
  • education12 college credits in ABA
    § 5240.81(f)(3)
Effective: 2019-10-19
BHT-ABA — 6 qualification pathways
BCaBA
BCaBA certification
  • credentialBCaBA certified
    § 5240.81(g)(1)
Effective: 2020-07-01
RBT
RBT certification
  • credentialRBT certified
    § 5240.81(g)(2)
  • ongoing training20 hours annual training
    § 5240.83(d)(2)
Effective: 2020-07-01
BCAT
BCAT certification
  • credentialBCAT certified
    § 5240.81(g)(3)
Effective: 2020-07-01
Other NCCA/ANSI Cert
Behavior analysis cert from NCCA or ANSI accredited org
  • credentialOther accredited behavior cert
    § 5240.81(g)(4)
Effective: 2020-07-01
40-Hour Training
HS diploma + 40hr RBT Task List training from BCBA/BCaBA
  • educationHS diploma or GED
    § 5240.81(g)(5)
  • training40-hr RBT Task List training
    § 5240.81(g)(5)
  • trainerTrainer must be BCBA/BCaBA
    § 5240.81(g)(5)
Effective: 2020-07-01
Experience + Training
2 years ABA experience + 40hr approved training
  • experience2 years ABA experience
    § 5240.81(g)(6)
  • training40 hours ABA training
    § 5240.81(g)(6)
Effective: 2020-07-01
Virginia
4 roles
Licensed Behavior Analyst (LBA)
BCBA-level
Can billCan supervise
Licensed Assistant Behavior Analyst (LABA)
BCaBA-level
Can billCan supervise
Licensed Mental Health Professional
LMHP
Can billCannot supervise
Technician (RBT/UBT)
Technician
Cannot billCannot supervise
Licensed Behavior Analyst (LBA) — 1 qualification pathway
Standard
BCBA with Virginia LBA license
  • credentialMust have current BACB certification
    18VAC85-150-60
  • licenseMust hold Virginia LBA license
    18VAC85-150-60
Effective: 2021-10-14
Licensed Assistant Behavior Analyst (LABA) — 1 qualification pathway
Standard
BCaBA with Virginia LABA license
  • credentialMust have current BACB certification
    18VAC85-150-60
  • licenseMust hold Virginia LABA license
    18VAC85-150-60
  • supervisionMust work under LBA supervision
    18VAC85-150-120
Effective: 2021-10-14
Licensed Mental Health Professional — 1 qualification pathway
Standard
LMHP with ABA training
  • licenseMust hold Virginia LMHP license
    DMAS MHS Manual
  • trainingMust have ABA training
    DMAS Bulletin 12/16/2025
  • limitationCannot supervise technicians
    DMAS Bulletin 12/16/2025
Effective: 2021-10-14
Technician (RBT/UBT) — 5 qualification pathways
LMHP Resident
LMHP-R/LMHP-RP/LMHP-S under supervision
  • credentialMust be LMHP in training status
    MHS Manual App D p.30
  • supervisionSupervised per board requirements
    MHS Manual App D p.30
Effective: 2021-10-14
LABA under LBA
LABA working under LBA supervision
  • licenseMust hold Virginia LABA license
    MHS Manual App D p.30
  • supervisionMust work under LBA supervision
    MHS Manual App D p.30
Effective: 2021-10-14
Personnel under LBA/LABA
Non-licensed staff under LBA or LABA
  • supervisionMust work under LBA or LABA
    18VAC85-150-10
Effective: 2021-10-14
Personnel under Psychologist
Non-licensed staff under Licensed Clinical Psychologist
  • supervisionMust work under licensed psychologist
    VA Code §54.1-3614
Effective: 2021-10-14
Licensed acting as Tech
LBA or LMHP billing at technician rate
  • credentialMust be licensed LBA or LMHP
    MHS Manual App D p.30
  • billingLicensed professional billing at tech level
    MHS Manual App D p.30
Effective: 2021-10-14
West Virginia
3 roles
BCBA / BCBA-D
BCBA-level
Can billCan supervise
BCaBA
BCaBA-level
Cannot billCan supervise
RBT
Technician
Cannot billCannot supervise
BCBA / BCBA-D — 1 qualification pathway
Standard
BCBA or BCBA-D certification
  • credentialMust have current BACB certification
    BMS 519.23.4
  • standingCertification must be in good standing
    BMS 519.23.4
  • enrollmentMust meet BMS enrollment criteria
    BMS 519.23.3
Effective: 2018-09-01
BCaBA — 1 qualification pathway
Standard
BCaBA under BCBA/BCBA-D supervision
  • credentialMust have current BACB certification
    BMS 519.23.4
  • standingCertification must be in good standing
    BMS 519.23.4
  • supervisionMust work under BCBA/BCBA-D supervision
    BMS 519.23.4
  • enrollmentMust meet BMS enrollment criteria
    BMS 519.23.3
Effective: 2018-09-01
RBT — 1 qualification pathway
Standard
RBT under BCBA/BCBA-D/BCaBA supervision
  • credentialMust have current BACB RBT credential
    BMS 519.23.4
  • supervisionMust work under BCBA/BCBA-D/BCaBA
    BMS 519.23.4
  • enrollmentMust meet BMS enrollment criteria
    BMS 519.23.3
Effective: 2018-09-01
Side-by-side reimbursement rate comparison across states for each CPT code. Rates shown by provider credential tier — useful for staffing cost analysis and multi-state expansion planning.
97151 — Behavior Identification Assessment
Provider TierDCMDPAVAWV
AllN/A
BCBA-level$38.34
BCBA-D-level$38.34
LABA-level$23.48
LBA-level$46.63
LMHP-level$39.40
97152 — Behavior ID Supporting Assessment
Provider TierDCMDPAVAWV
AllN/A
BCaBA-level$19.17
Technician$19.17
LABA-level$23.48
97153 — Adaptive Behavior Treatment by Protocol
Provider TierDCMDPAVAWV
All$27.50
BCaBA-level$20.91
BCBA-level$24.41
BCBA-D-level$24.41
Technician$19.17
LABA-level$23.48
LBA-level$46.63
LMHP-level$39.40
97154 — Group Adaptive Behavior Treatment by Protocol
Provider TierDCMDPAVAWV
All$18.43
BCBA-level$10.45
BCBA-D-level$10.45
BCaBA-level$8.36
Technician$6.96
LABA-level$15.60
LBA-level$15.55
LMHP-level$13.13
97155 — Adaptive Behavior Treatment with Protocol Modification
Provider TierDCMDPAVAWV
All$31.25
BCBA-level$38.34
BCBA-D-level$38.34
LABA-level$23.48
LBA-level$46.63
LMHP-level$39.40
97156 — Family Guidance (child present)
Provider TierDCMDPAVAWV
AllN/A
BCBA-level$20.91
BCBA-D-level$20.91
BCaBA-level$12.21
LABA-level$23.48
LBA-level$46.63
LMHP-level$39.40