What are the New 2026 Utah Medicaid Reimbursement Rates for Aba Therapy?
The Utah Medicaid ABA therapy rates for 2026 represent the reimbursement amounts set by the state for Applied Behavior Analysis (ABA) services. These updates, overseen by the Utah Division of Services for People with Disabilities (DSPD), have introduced significant coverage expansions to improve access for families across Salt Lake, Utah, Weber, and Davis counties.
While specific dollar amounts are not publicly disclosed in the fee schedule summaries, the 2026 rates are structured around specific billing codes that determine how your child’s treatment is covered. Key updates include:
- Billing Code 97153: This code covers face-to-face, one-on-one therapy between the patient and the therapist.
- Billing Code 97155: This code is utilized for essential clinical supervision by a Board Certified Behavior Analyst (BCBA).
- In-Home Coverage: A major shift in 2026 is the inclusion of In-Home ABA Therapy as a covered service, allowing children to receive evidence-based care in their natural environment rather than only in clinic settings.
- Expanded Parent Training: The updated program introduces greater flexibility for parent training and family collaboration, which is vital for skill generalization.
We encourage you to contact your specific Medicaid plan or reach out to us directly so we can help you verify your benefits and understand how the Utah Medicaid fee schedule 2026 applies to your situation. Our team manages the administrative side, including securing prior authorizations, to help your child begin their journey of Helping Children Reach their True Potential.
Results may vary based on individual circumstances. Insurance coverage and results depend on individual plans and client factors. This information is for educational purposes and is not a substitute for professional medical advice; consult a healthcare or behavioral health professional.
Related FAQs
-
How do I Choose an Aba Provider when There is a Long Waitlist?
Read More »: How do I Choose an Aba Provider when There is a Long Waitlist?When facing a long waitlist for ABA therapy, you can secure immediate care by following these strategic evaluation and enrollment steps: Related FAQs
-
How can I Find Aba Therapy Providers with no Waitlist?
Read More »: How can I Find Aba Therapy Providers with no Waitlist?Finding ABA therapy without an indefinite wait requires targeting providers with specific operational models and geographic flexibility. To secure immediate care, consider the following strategies: For a quick start, you can use tools like the Interactive ABA Roadmap to outline…
-
Are There Aba Providers in Utah with Immediate Openings?
Read More »: Are There Aba Providers in Utah with Immediate Openings?Yes, Golden Touch ABA Therapy provides in-home ABA therapy with no waitlist for families in Utah. They have structured their services to bypass the common 3–6 month delays found at many other centers. To secure an immediate opening in Utah,…
-
Are Self-funded Employer Plans Required to Follow State Autism Mandates?
Read More »: Are Self-funded Employer Plans Required to Follow State Autism Mandates?No, self-funded employer plans are generally not required to follow state autism mandates. While state-level autism insurance mandates require many private health insurance plans to cover treatments like Applied Behavior Analysis (ABA) therapy, these laws do not apply to every…
-
How Many Minutes of Therapy Represent One Billing Unit?
Read More »: How Many Minutes of Therapy Represent One Billing Unit?In ABA therapy billing, one billing unit represents 15 minutes of service. Standard Category I CPT codes, such as 97153 (direct therapy), 97155 (protocol modification), and 97156 (family guidance), are all billed in these 15-minute increments. The total number of…