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Family Behavior Therapy Guidance

New York rates for HCPCS 97156

This service is a session where a qualified provider meets with the family or caregivers of a patient, often a child with autism, to teach and guide them on how to support a behavior treatment plan at home. The patient may or may not be present, since the focus is on training the people who care for them day to day.

Rates data updated July 2026.

How much does Family Behavior Therapy Guidance cost?

$19.50

Typical negotiated rate. In New York, 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 $41.69 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 11 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$17.38 to $24.55
FacilityA hospital or hospital-owned outpatient department$41.69$24.55 to $234

How much rates vary

Facilitymedian $42 · 10th to 90th $22 to $389Professionalmedian $19 · 10th to 90th $16 to $31
$10.0$100.0$1.0K$10.0Kfacility $42professional $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
Facility
Modifier
Global
Typical Low
$21.88
Median
$131.83
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.50
Typical High
$25.12
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$19.05
Typical High
$20.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$16.98
Typical High
$24.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$30.20
Typical High
$123.03
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
$15.85
Median
$15.85
Typical High
$25.12
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$33.11
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$43.65
Typical High
$72.44
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
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
$17.38
Median
$19.50
Typical High
$19.50
United
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$23.99
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$44.67
Typical High
$79.43
Univera
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$20.42
Typical High
$41.69
Univera
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$36.31
Typical High
$72.44

Where New York sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New York $19.50 · 34th of 51
MA $25.12RI $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.