July 08, 2022

Louisiana Medicaid: Rate increase for applied behavioral analysis service

The Louisiana Department of Health (LDH) announced a reimbursement increase effective July 1, 2022, for applied behavioral analysis service procedure code 97153. This was announced in their informational bulletin 22-19

Rate increase
The rate for procedure code 97153 has increased to $12.50 per 15 minutes of adaptive behavior treatment by protocol, administered by a technician under the direction of a physician or other qualified health care professional. 

There is only one rate for this code, and no modifiers should be used with this code after July 1, 2022. 

Questions?
For answers to specific coverage or claims questions, call 866-675-1607, 7 a.m.– 7 p.m. CT, Monday–Friday. You can also refer to our claims process for more information, or LDH also offers provider resources.

PCA-1-22-02232-C&S-News_07072022