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Behavior Therapy Plan Adjustment by Provider

Virginia 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 $21 · 10th–90th $19$500%20%40%10th90th$21Professionalmedian $19 · 10th–90th $18$450%50%10th90th$19$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.05
Typical High
$24.55
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$46.77
Typical High
$67.61
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$30.20
Typical High
$38.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$27.54
Typical High
$40.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$32.36
Typical High
$40.74
Medcost
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$19.95
Typical High
$30.90
Medcost
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Sentara
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$44.67
Typical High
$89,125.09
Sentara
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$44.67
Typical High
$89,125.09
United
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$19.50
Typical High
$19.50
United
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$39.81
Typical High
$67.61