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Behavior Therapy Plan Adjustment by Provider

New York 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.

Facilitymedian $26 · 10th–90th $22$2630%20%10th90th$26Professionalmedian $19 · 10th–90th $15$330%50%10th90th$19$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$60.26
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.50
Typical High
$25.12
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$23.44
Typical High
$26.92
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$16.98
Typical High
$23.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$31.62
Typical High
$131.83
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$27.54
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$30.90
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$37.15
Typical High
$69.18
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Optum
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$21.38
Typical High
$21.38
United
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$26.30
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$44.67
Typical High
$77.62
Univera
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$20.42
Typical High
$39.81
Univera
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$35.48
Typical High
$69.18