Florida Medicaid ABA fee schedule 2026: codes, units and rates

AHCA’s Behavior Analysis Fee Schedule is incorporated by reference in Rule 59G-4.002¹⁸. Two versions of the rule matter now. The version in effect since January 18, 2026 incorporates the schedule dated January 1, 2025³. An amendment filed on October 6, 2026 incorporates the schedule dated January 1, 2026 and takes effect on October 26, 2026². AHCA’s rule page offers the 2026 document as the “Updated” schedule and the 2025 one as “Promulgated”⁶. The AHCA PDF is titled “Behavior Analysis Fee Schedule 2026”, and the adopted copy on flrules.org is dated January 1, 2026¹⁷.

The key point: we compared the October 2024, January 2025 and January 2026 schedules row by row, and every maximum fee and every unit limit is identical¹⁴⁵. The official documents show no rate change. The notices do not explain how the January 1 date applies to services delivered before October 26, so confirm that with AHCA or your plan if it matters for a claim.

The table shows the maximum fee per 15-minute unit in the 2026 schedule¹⁷. The schedule does not name who provides 97151, 97152, 0362T or 0373T, so the “Who” column for those follows AHCA’s slide of August 12, 2026⁹. The coverage policy defines who can be a lead analyst, a BCaBA or an RBT⁸.

Source: Behavior Analysis Fee Schedule 2026, AHCA, dated January 1, 2026¹⁷. In the group codes, each added client lowers the fee by $0.50¹. The schedule marks 97153 and 97155 with the XP modifier, a supervisee under concurrent supervision, as “Not reimbursed”, and the supervisor may be reimbursed instead¹. For what each code means, see our CPT codes explainer.

Every amount above is per 15-minute unit¹. The coverage policy says providers may claim only services performed for 8 minutes or more when determining billable units. For services over 15 minutes, you divide the total minutes by 15. Leftover minutes of 8 or more count as one unit, and fewer than 8 do not count⁸.

Two examples, by simple arithmetic on that rule: 53 minutes is 3 full units plus 8 leftover minutes, so 4 units. 52 minutes is 3 units, because 7 leftover minutes do not count. A one-hour session is 4 units, so at the maximum fee it is $49.04 for 97153 and $76.68 for 97155 by a lead analyst.

• Assessment: up to 24 units of 97151 and 8 of 97152 per behavior assessment, so at most $457.20 for 97151¹. A reassessment (97151 TS) is limited to 18 units¹.
• Add-ons: 0362T allows up to 16 units in an initial assessment or reassessment, and it needs prior authorization and medical necessity. 0373T also needs prior authorization and medical necessity¹.
• Family training by telemedicine: reimbursed up to 2 hours per week¹.
• Groups: maximum of 6 clients per group¹.
• Weekly hours: the policy covers up to 40 hours of intervention per week, as the authorized behavior plan indicates⁸. That is 160 units.
• Under 21: the limits are not absolute. For recipients under 21, services beyond the policy or the fee schedule may be approved if they are medically necessary⁸.
• Concurrent practitioners: if more than one practitioner provides concurrent services, only one is reimbursed, unless it is medically necessary, prior authorized and written in the approved behavior plan¹.
• Not covered: services not listed on the fee schedule, and travel time⁸. The schedule does not list 97157, so confirm with your plan before billing it¹⁸.

For the authorization side, see our guide to prior authorization.

On August 12, 2026, AHCA presented a slide titled with the 2026 fee schedule. It shows the lead analyst at $19.05 for assessment and reassessment, and BCaBA or RBT at $12.19 for the supporting assessment, per 15-minute unit⁹.

Some rows of that slide are summaries that do not match the schedule. It shows treatment by protocol at $12.19, while the schedule lists 97153 at $12.26. It shows treatment with protocol modification at $19.05 for the lead analyst and $15.24 for the BCaBA, while the schedule lists $19.17 and $15.37. It also opens group services with protocol modification to RBTs, while the schedule says lead analyst or BCaBA¹⁹. For billing, use the schedule and the coverage policy, not the slide.

Since February 2025, claims for children enrolled in a plan go to that plan, and providers must contract with it to be reimbursed¹⁰. AHCA reported that 98.9% of recipients receiving ABA are in an SMMC plan, and its slide lists provider payment among the functions plans manage⁹. During continuity of care, the plan pays the rate the provider previously received for up to 60 days¹⁰.

The AHCA documents we reviewed do not state what plans pay per code, nor a minimum rate. Do not assume your plan pays the fee-for-service schedule: ask for the fee schedule in your contract.

The 2026 schedule becomes part of Rule 59G-4.002 on October 26, 2026². The coverage policy is still the December 2024 version, whose rule has no newer adopted version than February 10, 2025⁸¹². The ABA Task Force must report by December 31, 2026, and its October 5 agenda included an item linking assessment, treatment duration and payment¹¹. Nothing has been adopted. Read our explainer on the task force and check the rule page before you rely on any amount.