MedicaidReimbursementMedium impact
MMP 24-51: Implementation of the Legislatively Mandated Behavioral Health Treatment (BHT)-Applied Behavior Analysis (ABA) Rate Increase
Michigan Medicaid - MDHHS·MI · Psychiatry, Pediatrics·Claims & Billing
Effective date
Nov 1, 2024
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has increased the minimum reimbursement rate for Applied Behavior Analysis (ABA) services to $16.50 per unit or $66.00 per hour for CPT code 97153, effective November 1, 2024. This legislatively mandated rate increase applies to Medicaid and Healthy Michigan Plan beneficiaries receiving autism treatment services.
Action Required
Immediately: Billing team should verify that claims for CPT code 97153 (BHT-ABA services) submitted to Michigan Medicaid PIHPs are being reimbursed at the new minimum rate of $16.50 per unit or $66.00 per hour. Review recent payments to ensure compliance with the new rate structure for Medicaid and Healthy Michigan Plan patients.