The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 97151. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
32
Median % of Medicare
--
Rate range
$7.50 - $882.78
97151 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $25.00 | -- | -- | 2026 |
| Arkansas | $20.00* | -- | -- | 2026 |
| Arizona | $33.27 | -- | -- | 2024 |
| Colorado | $882.78 | -- | Required | 2026 |
| Georgia | $20.35 | -- | -- | 2026 |
| Hawaii | $28.52 | -- | -- | 2025 |
| Illinois | $163.12* | -- | Required | 2026 |
| Indiana | $20.56* | -- | Required | 2026 |
| Kansas | $43.75 | -- | -- | 2019 |
| Kentucky | $27.50* | -- | -- | 2026 |
| Louisiana | $7.50 | -- | -- | 2026 |
| Michigan | $103.79 | -- | -- | 2026 |
| Minnesota | $50.11 | -- | Conditional | 2024 |
| Missouri | $91.58 | -- | Varies | 2026 |
| Mississippi | $77.15 | -- | -- | 2026 |
| North Carolina | $18.67 | -- | -- | 2025 |
| North Dakota | $31.76 | -- | Required | 2026 |
| Nebraska | $27.42 | -- | -- | 2026 |
| New Hampshire | $16.43 | -- | Varies | 2026 |
| New Jersey | $25.00 | -- | Not required | 2026 |
| New Mexico | $112.65* | -- | -- | 2026 |
| Nevada | $29.14 | -- | -- | 2025 |
| New York | $19.26 | -- | -- | 2026 |
| Oklahoma | $23.55 | -- | -- | 2026 |
| Pennsylvania | $22.09 | -- | -- | 2023 |
| Rhode Island | $45.34 | -- | -- | 2026 |
| Texas | $27.56* | -- | -- | 2025 |
| Utah | $37.51* | -- | Not required | 2026 |
| Virginia | $46.63 | -- | -- | 2021 |
| Vermont | $65.80 | -- | -- | 2019 |
| Washington | $18.79 | -- | -- | 2026 |
| Wyoming | $24.60* | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related physician codes
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
- 10060 - Drainage of a skin abscess, simple
- 10061 - Drainage of a skin abscess, complicated or multiple
- 10120 - Removal of a foreign body from tissue, simple
- 10140 - Drainage of a blood or fluid collection under the skin
- 11042 - Wound debridement, skin and tissue below, first 20 sq cm
- 11043 - Wound debridement to muscle, first 20 sq cm
- 11044 - Wound debridement to bone, first 20 sq cm
Frequently asked questions
How much does Medicaid pay for 97151?
32 state Medicaid programs publish a fee-for-service rate for 97151 (behavior identification assessment (ABA), each 15 minutes), ranging from $7.50 in Louisiana to $882.78 in Colorado. The full table on this page lists every publishing state's current rate.
Which state pays the most for 97151?
Colorado publishes the highest Medicaid rate for 97151 at $882.78. Louisiana publishes the lowest at $7.50.
Does 97151 require prior authorization under Medicaid?
5 of the 32 publishing states flag 97151 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".