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CPT code 97153: Adaptive behavior treatment, one patient, technician2026 Medicare rate & RVUs

Reports face-to-face, one-to-one adaptive behavior treatment delivered by a technician following an established protocol, in 15-minute units.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 97153

Adaptive behavior treatment, one patient, technician

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 97153 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 97153 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 97153 covers

A behavior technician uses an established treatment protocol to work directly with one patient on adaptive behavior goals. This service is commonly part of applied behavior analysis, including treatment for autism-related behavioral needs. The technician delivers the protocol under the direction of a physician or other qualified health care professional; the code describes treatment, not an assessment or a group session.

Report the service in 15-minute units for face-to-face treatment. CMS assigns status C, or carrier priced, under the physician fee schedule: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Select a different code when a technician is supporting an assessment, treatment is delivered to a group, or a physician or qualified health care professional provides treatment involving protocol modification.

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 97153 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

97153 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

97153 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
97153 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 97153 rate is calculated

Each of 97153’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 · 97153

RVUs × geographic indexes × conversion factor

Office or facility?

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 97153

97153 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 · 97153

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

97153 isn’t priced in this setting.

97153 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 97153

    Adaptive behavior treatment, one patient, technician0 wRVU

    Not priced

  • 97154

    Group behavior treatment, technician, per 15 minutes0 wRVU

    Not priced

  • 97155

    Behavior treatment, protocol modification0 wRVU

    Not priced

  • 97152

    Behavior assessment, technician support0 wRVU

    Not priced

How to choose

97154Group behavior treatmentTechnician, per 15 minutes
Choose 97153 for technician treatment with one patient; choose 97154 when the technician delivers adaptive behavior treatment in a group.
97155Behavior treatmentProtocol modification
97153 is technician implementation of an established protocol. 97155 is treatment by a physician or qualified health care professional involving protocol modification.
97152Behavior assessmentTechnician support
97152 concerns technician support during behavior identification assessment; 97153 reports treatment under an established protocol.

Codes related to 97153

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 97153
CodeHow it relatesNational office range
Same family
97154Group behavior treatment, technician, per 15 minutesTechnician-delivered adaptive behavior treatment for a group rather than one patient.No office rate
97155Behavior treatment, protocol modificationAdaptive behavior treatment involving protocol modification by a physician or qualified health care professional.No office rate
97158Group adaptive treatment, QHP protocol modificationGroup adaptive behavior treatment provided by a physician or qualified health care professional.No office rate

97153 billing questions

How many minutes does one unit represent?

One unit represents 15 minutes of face-to-face adaptive behavior treatment delivered by a technician to one patient.

When should 97154 be used instead?

Use 97154 for technician-delivered adaptive behavior treatment in a group. Use 97153 for treatment delivered to one patient.

How does 97153 differ from 97155?

97153 describes a technician implementing an established protocol with one patient. 97155 describes treatment by a physician or qualified health care professional involving protocol modification.

Is 97153 an assessment code?

No. It reports treatment under a protocol. Technician support for a behavior identification assessment is described by 97152.

How does Medicare price 97153?

CMS assigns status C, or carrier priced, under the physician fee schedule. CMS publishes no national payment; 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

Open CMS sourceHow we calculate rates

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