ABA Coding Coalition Letters in Support of ABA Providers

January 21, 2026

As 2025 came to an end and 2026 has begun, the Coalition continues to advocate for the ABA community, reaching out to several Medicaid and Commercial payors, based on provider feedback and inquiries. To submit inquiries or concerns regarding the use of theadaptive behavior CPT® codes, use the Contact feature on the website.

• Michigan

The Coalition reached out to Blue Cross Blue Shield of Michigan (BCBSM) regarding recently imposed restrictions on documentation practices for CPT Code 97153 (adaptive behavior treatment by protocol), which limited the duration that a single session note could document to no more than two hours and thirty minutes.

• Virginia

We engaged with the Virginia Department of Medical Assistance Services (DMAS) around their current policy restrictions related to concurrent billing of CPT codes 97151 (Behavior identification assessment) and 97153 (Adaptive behavior treatment by protocol).

• Vermont

The Coalition submitted comments and recommendations in response to a provider notice issued by the Department of Vermont Health Access (DVHA) outlining policy changes for billing ABA services, effective January 1, 2026, which included the discontinuation of concurrent billing for CPT codes 97153 and 97155 and limiting ABA services delivered through telehealth to CPT codes 97155, 97156, and 97157. Comments also included clarification around the intended use of the terms direction and supervision.

• Texas

The Coalition reached out to Texas Health and Human Services Commission concerning their restrictions around concurrent billing for CPT codes 97153 (Adaptive behavior treatment by protocol) and 97155 (Adaptive behavior treatment with protocol modification, as well as potential limitations on authorized hours for these services.