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Behavior Therapy Plan Adjustment by Provider

Montana rates for HCPCS 97155

This service is a hands-on session where a qualified provider directly works with a patient, most often a child with autism, to observe how a behavior support plan is going and make adjustments in real time. It differs from sessions run by a trained technician because the treating provider is personally present and actively modifying the approach based on what they see.

Rates data updated July 2026.

How much does Behavior Therapy Plan Adjustment by Provider cost?

$19.50

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $19.50 for this service. The price depends on where it is billed: about $19.50 from a physician practice, and about $20.42 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$19.50$19.05 to $21.88
FacilityA hospital or hospital-owned outpatient department$20.42$19.05 to $28.18

How much rates vary

Facilitymedian $20 · 10th to 90th $18 to $41Professionalmedian $19 · 10th to 90th $18 to $26
$20$50$100$200facility $20professional $19

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.50
Typical High
$24.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$29.51
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$25.12
Typical High
$40.74
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$229.09
Typical High
$245.47
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$229.09
Typical High
$245.47
Providence
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$19.50
Typical High
$30.20
Providence
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$60.26
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$51.29
Typical High
$64.57

Where Montana sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 16th of 51

$19.50

NC $25.12AR $19.05

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.