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A Complete Guide to CPT Code 97152 for ABA Therapists
- Veronica Cruz
- 3 days ago
- 5 min read
Understanding how to use CPT code 97152 can save you time, protect your practice from billing mistakes, and make sure you get paid for the important work you do. Whether you're a new ABA therapist or an ABA billing team member trying to make sense of coding rules, this guide breaks everything down clearly so you can understand it, use it correctly, and avoid costly mistakes.
What Is CPT Code 97152?
CPT code 97152 is the official way to bill for the time you spend assessing a client’s behavior before starting treatment. Think of it as your detective phase—you’re gathering clues, observing behaviors, and understanding what makes your client act the way they do.
The 97152 CPT code description reads
Behavior identification assessment, administered by a behavior analyst, per 15 minutes, face-to-face with the client, parent, or guardian.
Every 15 minutes you spend directly assessing the client or interviewing the caregiver counts as one billing unit.
So, if you spend an hour observing and talking to the family, that’s four units of CPT code 97152.
For example, a 60-minute behavior assessment equals four units of CPT code 97152.
When to Use CPT Code 97152
The 97152 ABA code plays a central role in the early and ongoing stages of ABA therapy. It’s designed for technicians who are directly observing, interacting, and assessing clients to support behavior identification. Here are the most common scenarios where 97152 applies:
Initial Assessments
When a new client starts ABA therapy, the RBT conducts an initial assessment to understand their behaviors and challenges. This may include structured play, observation, and direct interaction to pinpoint what needs to be addressed.
Example
An RBT works with a new client named Leo, who struggles with sudden tantrums during transitions. The technician observes Leo during play and meal times, noting triggers and patterns. The assessment lasts 60 minutes—billed as four units of 97152.
Reassessments
As therapy progresses, periodic reassessments help track improvement and determine whether interventions are effective.
Example
After six months of therapy, the RBT reassessed Leo to measure changes in his behavior. This helps the BCBA decide if the current plan is working or needs changes. Each 15-minute block of this reassessment is billed under the 97152 CPT code.
Transition Assessments
When a client moves from one setting to another—say, from home to school or vice versa—a reassessment helps adapt the plan to the new environment.
Example
An RBT observes a teenager with ASD during school recess and later at home during dinner. The observations reveal different triggers in each setting. These face-to-face assessments are billed using CPT code 97152.
Post-Intervention Assessments
After completing a treatment module, it’s essential to measure results.
Example
After three months focusing on improving social interaction, the RBT observes how the client initiates play with peers. The post-intervention evaluation helps confirm if goals were met and is billed under the 97152 ABA code.
When Not to Use CPT Code 97152
This is important. Not every ABA session qualifies for this code. Some clinics make the mistake of billing 97152 for regular sessions, which can lead to insurance denials.
Don’t use 97152 when
You’re running regular therapy sessions (use 97155 instead).
You’re training parents or caregivers (that’s 97156).
You’re supervising staff or doing paperwork without the client.
97152 is only for the assessment phase. Once you start working on behavior change plans, switch to other CPT codes.
Benefits of Correctly Using CPT Code 97152
Accurate Reimbursement: Correct coding ensures your practice gets paid for all the work done. Mistakes can lead to delays or outright denials.
Audit-Ready Documentation: Clear notes protect your practice during insurance audits by showing transparency and compliance.
Improved Clinical Quality: Proper assessments mean more personalized treatment plans—and better results for clients.
If you’re planning to launch your own ABA practice, our step-by-step guide explains how to set up efficient billing and documentation workflows from day one.
Documentation Requirements
Proper documentation is the difference between smooth reimbursement and claim denials. Each session note should clearly describe what happened, why it was necessary, and how long it took.
What to Include in Your Notes
Date and total duration of the assessment
Number of units billed (1 unit = 15 minutes)
Type of assessment activities (observation, structured play, record review, interview)
Behavioral findings and next steps
Supervising BCBA’s name and credentials
Need a deeper dive into writing clear, audit-ready progress notes? Visit our guide on ABA Therapy Documentation—How to Write Better Session Notes
Example of a Session Note
Date: November 7, 2025 Time: 9:00 AM – 10:00 AM Total Duration: 60 minutes (4 units of CPT code 97152) Therapist: Lisa Moore, RBT Supervisor: Dr. Brian Chase, BCBA-D
Activities Performed
Observed client during playtime to identify triggers (15 min)
Interviewed caregiver about in-home behaviors (15 min)
Conducted structured observation with prompts (15 min)
Recorded frequency of self-stimulatory behaviors (15 min)
Findings: The client displayed increased vocal protests when denied access to preferred items.
Recommendations: Begin treatment targeting functional communication.
Learn key practices to keep your clinic compliant and audit-ready with proper ABA Medicaid documentation and coding.
Quick Comparison: 97152 vs. Related ABA Codes
Knowing which code to use and when saves hours of claim rework.
Compliance and Insurance Rules
To get paid and stay out of trouble with insurance, follow these basic rules when using CPT code 97152:
Why It’s Needed: Always explain why you’re doing the assessment. Is there a new diagnosis? Did a doctor or teacher refer the client?
Time Tracking: One unit means 15 minutes. Don’t round up or overlap time with other codes.
Who Can Bill: Only qualified professionals, like BCBAs, can bill 97152. RBTs can help, but can’t bill by themselves.
Supervision: Some states ask for the BCBA to be there or at least available. If that's required, write it in your notes.
Insurance companies are asking for more details than before. Instead of writing a 1-hour assessment, you now need to show what was done every 15 minutes. Also, many states updated their billing rules. Always double-check your state’s Medicaid or private insurance guidelines. What worked last year may not be okay today.
For BCBAs and BCaBAs aiming to stay current with billing and ethical standards, review our Guide to CEU Requirements for BCBAs and BCaBAs
FAQ
1. What CPT codes are used for ABA therapy?
Common codes include 97151 (initial assessment), 97152 (behavior identification assessment), 97153 (direct treatment), 97155 (adaptive behavior treatment), and 97156 (parent training).
2. Can 97151 and 97152 be billed concurrently?
Yes, but only if the services are distinct. Use 97151 for intake-level assessments and 97152 for hands-on observation and interviews with the client and family. Never overlap time.
3. What is code 97152 in ABA?
97152 ABA code is used to document the behavior identification assessment. It includes time spent directly with the client and family to observe behaviors, gather information, and plan next steps—billed in 15-minute units.
Conclusion
When used right, CPT code 97152 isn’t just a number—it’s the first step in understanding your client’s world. But when mishandled, it can lead to delayed payments and unnecessary financial headaches. The key lies in maintaining clear session notes, accurate time logs, and a solid billing workflow that supports compliance.
Keep your team trained, your documentation tight, and your process compliant.
Need help with ABA billing or auditing 97152 usage? Talk to ABA billing pros who know the game inside and out.
