MedicaidBilling CodesMedium impact
Concurrent billing for Applied Behavior Analysis (ABA) codes
Oregon Health Plan·OR · Psychiatry·Provider
Effective date
Jan 12, 2024
We identified it
Jun 20, 2026
Summary
Oregon Health Authority now allows concurrent billing of ABA codes 97155 (professional) and 97153 (technician) when both services are provided simultaneously, up to 4 units or 1 hour total, with proper supervision and documentation. Previously these codes could not be billed together for the same time period.
Action Required
Immediately: Billing team must update system to allow concurrent billing of CPT 97155 and 97153 for Oregon Medicaid patients when both professional and technician provide ABA services simultaneously. Ensure claims include proper documentation per Oregon Administrative Rule 410-172-0620 showing medical necessity, appropriate supervision, and that concurrent activities do not exceed 4 units or 1 hour. Contact Oregon Provider Services at 1-800-336-6016 option 5 for fee-for-service questions or member's CCO for managed care questions.