Complete Guide to CPT Code 97151

CPT Code 97151 is a foundational code in Applied Behavior Analysis (ABA) services. It is used for behavioral assessments that guide treatment planning and establish a clear roadmap for patient care. Medical coders, ABA providers, and healthcare organizations must understand this code to ensure accurate billing and compliance.

This blog explains what CPT Code 97151 is, when to use it, who can bill it, and key documentation requirements—based on common search intent and real-world billing questions.

What Is CPT Code 97151?

CPT Code 97151 is used for behavior identification assessment services. These assessments are performed to evaluate a patient’s behavioral needs and to develop or update an ABA treatment plan.

The code includes:

• Clinical interviews
• Direct observation
• Data analysis
• Review of records
• Development of treatment goals

Unlike most ABA treatment codes, 97151 is not time-based.

Official Description of CPT Code 97151

CPT 97151 describes:

Behavior identification assessment, by physician or other qualified health care professional, including administration of standardized and non-standardized tests, detailed behavioral history, patient observation, caregiver interview, and treatment plan development.

When to Use CPT Code 97151

CPT 97151 should be used when:

• Conducting an initial ABA assessment
• Performing a reassessment due to clinical changes
• Developing or significantly updating a treatment plan
• Reviewing patient progress that requires new goals or strategies

It is typically billed at the start of care or when a major treatment update is needed.

Is CPT Code 97151 Time-Based?

No. CPT 97151 is an untimed code.

This means:

• You do not bill in 15-minute increments
• The focus is on completion of the assessment, not duration
• Documentation must justify the medical necessity of the assessment

Who Can Bill CPT Code 97151?

CPT 97151 must be billed by a qualified healthcare professional, such as:

• Board Certified Behavior Analysts (BCBAs)
• Licensed behavioral health providers (based on payer rules)
• Physicians qualified to provide ABA services

Behavior technicians cannot bill this code.

Patient and Caregiver Presence

• The patient may or may not be present for all components
• Caregiver interviews are commonly included
• Record review and data analysis can be performed without the patient present

CPT 97151 vs Other ABA CPT Codes

Key Difference:
CPT 97151 is assessment-only, not treatment.

Documentation Requirements for CPT 97151

Strong documentation is critical for reimbursement. Records should include:

• Reason for the assessment
• Clinical history and presenting concerns
• Assessment tools or methods used
• Behavioral observations
• Caregiver interview summaries
• Functional analysis (if applicable)
• Treatment goals and recommendations

Incomplete assessments are a common reason for claim denials.

Common Billing Mistakes to Avoid

• Billing 97151 for direct therapy sessions
• Using 97151 for minor plan updates
• Missing treatment plan development in documentation
• Billing reassessments without medical necessity
• Confusing 97151 with time-based ABA codes

Why CPT Code 97151 Is Important

CPT Code 97151 ensures that ABA treatment is data-driven and individualized. It allows providers to establish measurable goals, track progress accurately, and justify medical necessity for ongoing services.

For payers, it supports responsible utilization. For providers, it lays the foundation for effective treatment.

Final Thoughts

CPT Code 97151 is a critical starting point for ABA services. When used correctly, it supports ethical care, accurate billing, and better patient outcomes. Understanding when and how to apply this code helps medical coders and providers stay compliant while delivering high-quality behavioral health services.

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