CPT code 97152: Behavior assessment, technician support2026 Medicare rate & RVUs in New Jersey
Reports each 15 minutes of technician face-to-face behavioral assessment support directed by a physician or qualified health care professional.
CMS doesn’t publish an office rate for 97152 in New Jersey.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 97152 covers
97152 represents face-to-face behavioral assessment support provided by a technician under the direction of a physician or other qualified health care professional. It is part of the behavioral identification assessment process, rather than adaptive behavior treatment. In behavioral health and applied behavior analysis settings, the technician works directly with the patient and supplies information used in the professional’s assessment. The professional assessment service is represented separately by 97151.
Medicare assigns this code physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. One unit represents 15 minutes of the technician’s face-to-face time with the patient. Count the technician’s qualifying time, not the professional’s assessment time.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 97152 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | Unavailable | Unavailable |
| Rest of New Jersey | Unavailable | Unavailable |
How the 97152 rate is calculated
Each of 97152’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 97152
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97152
97152 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 97152
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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97152 isn’t priced in this setting.
97152 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 97151Behavior assessmentPhysician or QHP
- 97151 represents the professional’s behavioral assessment service. 97152 represents technician time supporting that assessment under the professional’s direction.
- 97153Adaptive behavior treatmentOne patient, technician
- 97153 represents adaptive behavior treatment delivered by a technician. Use 97152 for technician assessment support, not treatment.
- 97155Behavior treatmentProtocol modification
- 97155 represents adaptive behavior treatment with protocol modification by a physician or qualified professional; 97152 represents technician assessment support.
97152 billing questions
When should I use 97152 rather than 97151?
Use 97152 for the technician’s face-to-face work supporting the assessment. Code 97151 represents the physician’s or other qualified health care professional’s assessment service.
Is 97152 an assessment or a treatment service?
It represents technician assessment support, not adaptive behavior treatment. Code 97153 describes technician-delivered adaptive behavior treatment.
How many minutes does one unit represent?
One unit represents 15 minutes of face-to-face technician time with the patient.
Who directs the technician’s work?
A physician or other qualified health care professional directs the supporting assessment.
How does Medicare price 97152?
It has physician fee schedule status C. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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