Billing Codes

The CPT® codes below have been approved by the American Medical Association (AMA) for applied behavior analysis assessment and treatment – described as “adaptive behavior services” in the 2027 CPT® code book. Adaptive behavior services address deficient adaptive behaviors (e.g., instruction following, verbal and nonverbal communication, imitation, play and leisure, social interactions, self-care, daily living, personal safety skills) or harmful behaviors (e.g., repetitive and stereotypic behaviors; behaviors that risk physical harm to the patient, others, and/or property). These codes take effect on January 1, 2027.

Adaptive Behavior Assessment

97151. Behavior identification assessment, administered by a physician or other qualified health care professional (QHP), each 15 minutes of the physician’s or other QHP’s time face-to-face with patient and/or caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring and/or interpreting the assessment, and preparing the report and/or treatment plan

97152. Behavior identification–supporting assessment, administered by technician, face-to-face with the patient, each 15 minutes

97148. Behavior identification–supporting assessment of harmful behavior; each 15 minutes of technician time face-to-face with a patient, requiring the following components:

  • delivered by 2 technicians,
  • for a patient who exhibits harmful behavior,
  • conducted in an environment that is customized to the patient’s behavior.

+97149. each additional technician present, each 15 minutes (List separately in addition to code for primary procedure)

(Use 97149 in conjunction with 97148)

(Use 97148 when only 2 technicians are performing the assessment)

(Use 97149 to report the sum of the time of the 3rd through 5th technicians)

Adaptive Behavior Non-Face-to-Face Services

97180. Adaptive behavior non-face-to-face services, personally performed by a physician or other qualified health care professional, each 15 minutes, with any of the following elements, when performed:

  • review and analysis of data and session notes on patient treatment targets,
  • clinical decision-making regarding the need to modify treatment targets, goals, or protocols and/or making those modifications,
  • clinical decision-making regarding the need for additional assessment and developing or modifying assessment protocols,
  • developing discharge or transition plan,
  • training on or reviewing treatment targets and/or revised assessment or treatment protocols with technician(s).

Adaptive Behavior Treatment

97153. Adaptive behavior treatment by protocol, administered by technician, face-to-face with 1 patient, each 15 minutes

97154. Group adaptive behavior treatment by protocol, administered by technician, face-to-face with 2 or more patients, each 15 minutes

97159. Adaptive behavior treatment of harmful behavior; each 15 minutes of technician time face-to-face with a patient, requiring the following components:

  • delivered by 2 technicians,
  • for a patient who exhibits harmful behavior,
  • conducted in an environment that is customized to the patient’s behavior.

+97160. each additional technician present, each 15 minutes (List separately in addition to code for primary procedure)

(Use 97149 in conjunction with 97148)

97155. Adaptive behavior direction of technician and analysis by physician or other QHP, face-to-face with a patient, each 15 minutes

97173. Adaptive behavior treatment with analysis, administered by physician or other qualified health care professional, face-to-face with 1 patient, each 15 minutes

97156. Family adaptive behavior treatment guidance with analysis, administered by physician or other qualified health care professional (with or without the patient present), including discussing protocols and treatment targets and/or training the caregiver(s) to implement assessment or treatment protocols with the patient, face-to-face with caregiver(s) for 1 patient, each 15 minutes

97157. Multiple-family group adaptive behavior treatment guidance with analysis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of caregivers for multiple patients, each 15 minutes

97158. Group adaptive behavior treatment with analysis, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes