CPT Code 97153 is one of the most commonly used codes in Applied Behavior Analysis (ABA) therapy. It is primarily used for direct one-on-one behavioral therapy delivered by a Registered Behavior Technician (RBT) under supervision. Understanding this code is essential for providers, billers, and families navigating ABA services.
What Is CPT Code 97153?
CPT 97153 describes:
Adaptive behavior treatment by protocol, administered by a technician under the direction of a qualified healthcare professional, face-to-face with the patient, each 15 minutes.
This code is specifically designed for direct treatment of patients, usually children with autism spectrum disorder (ASD) or other developmental conditions.
When to Use CPT Code 97153
CPT 97153 should be billed when:
- A behavior technician delivers direct ABA therapy.
- The service is face-to-face with the patient.
- The session is conducted under the supervision of a BCBA or qualified professional.
- The treatment follows a structured behavior plan or protocol.
It is not used for caregiver training, assessments, or supervision alone.
Time and Billing
- CPT 97153 is billed in 15-minute increments.
- Accurate start and end times must be recorded.
- Example: A 45-minute ABA session = 3 units of 97153.
Documentation should clearly note the specific skills targeted, patient response, and progress toward goals.
Who Can Provide CPT 97153 Services?
- Registered Behavior Technicians (RBTs) or equivalent technicians provide the service.
- BCBAs or licensed supervisors oversee and guide the therapy.
- Technicians cannot bill independently—billing is submitted by the supervising provider.
CPT 97153 vs Other ABA Codes
| CPT Code | Service | Who Provides | Patient Presence |
|---|---|---|---|
| 97151 | Initial Assessment | BCBA | Optional |
| 97152 | Observation/Direction | BCBA | Required |
| 97153 | Direct Treatment | Technician | Required |
| 97155 | Protocol Modification | BCBA | Optional |
| 97156 | Family Guidance | BCBA | Optional |
Key Point: 97153 is direct treatment, whereas 97155 and 97156 are caregiver-focused.
Documentation Requirements
Proper documentation ensures compliance and reimbursement. Key elements include:
- Date, start, and end time
- Provider credentials and roles
- Target skills and behavior plans
- Patient response and progress notes
- Any changes or adjustments made during the session
Common Mistakes to Avoid
- Billing 97153 for caregiver training or supervision sessions
- Overlapping billing with 97152 or 97155
- Incomplete documentation of patient interactions or outcomes
- Not recording 15-minute increments accurately
Importance of CPT Code 97153
CPT 97153 is crucial for delivering structured ABA therapy. It allows patients to work on skill acquisition, behavior reduction, and independence while giving supervisors clear documentation for progress tracking.
Final Thoughts
CPT Code 97153 is the foundation of most ABA treatment programs. By understanding when to use it, who can provide it, and how to document it, providers and families can ensure effective therapy, proper billing, and measurable patient progress.
FAQs:
1. What is CPT Code 97153?
CPT 97153 is used for adaptive behavior treatment provided by a technician under the supervision of a qualified healthcare professional, commonly in ABA therapy.
2. Who can bill CPT Code 97153?
The code is billed by the supervising provider (such as a BCBA), but the service is performed by a technician (e.g., RBT).
3. What type of service does 97153 cover?
It covers direct, one-on-one adaptive behavior treatment, following a treatment plan designed by a qualified professional.
4. Is CPT 97153 time-based?
Yes. It is billed in 15-minute units.
5. Does CPT 97153 include supervision?
No. Supervision is not included. Supervision is billed separately using codes like 97155.