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

CMS doesn’t publish a rate for 97153 in Virginia.

Check a contract rate as a % of Medicare · 97153 nationwide

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

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.

How Virginia compares for 97153

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97153 rates by state

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

See 97153 in every payment locality

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.

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.

Codes related to 97153

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

How 97153 has changed in Virginia

Price 97153 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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