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Vermont ABA Medicaid rates

Not yet verified

Current published Medicaid rates, dated changes, and what they mean. Last checked Oct 20, 2026.

Current rates

97153 · Technician direct therapy (RBT)

Not yet verified. We haven't confirmed a current 97153 rate for Vermont from an official source yet. Have the fee schedule? Send it.

97155 · Protocol modification (BCBA)

Not yet verified. We haven't confirmed a current 97155 rate for Vermont from an official source yet. Have the fee schedule? Send it.

What it means

For clinic owners

Since Jan 1, 2026, 97153 and 97155 cannot be billed for the same member at the same time, and only 97155/97156/97157 may be delivered by telehealth. On July 1, 2026 Vermont replaced the tiered monthly case rate with fee-for-service. The state's own estimate of the coding change is about $1.43M a year in savings.

For BCBAs & RBTs

BCBA overlap time with a technician is no longer separately billable, so supervision has to be scheduled and documented differently. DVHA lets only BCBAs bill 97155.

Change log

  • Billing ruleIn effectJul 1, 2026

    ABA moves from tiered case rate to fee-for-service

    DVHA stops reimbursing the tiered monthly case rate; all ABA billed fee-for-service. Expected to be budget neutral. The state said it will not reverse the concurrent-billing ban.

    Source: Vermont GCR 26-058 (final) · Verified: official source · checked Oct 20, 2026
  • Billing ruleIn effectJan 1, 2026

    Concurrent billing of 97153 + 97155 banned

    97153 and 97155 can no longer be billed for the same member at the same time (same day at different times is allowed). Telehealth limited to 97155/97156/97157. Estimated savings $1,433,813/yr.

    Source: Vermont GCR 25-042 (final) · Verified: official source · checked Oct 20, 2026

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