How and When to Use CPT Codes 97157 and 97158 in ABA Therapy

If you've ever felt confused about CPT codes 97157 and 97158, you're not alone. These ABA billing codes look similar at first glance. Both cover group therapy. Both involve multiple patients. Both are billed in the same time increments.

These codes are powerful when used correctly and risky when they’re not. Misuse can lead to denials, recoupments, or worse, compliance issues during audits. What this really means is that understanding how and when to use CPT codes 97157 and 97158 is no longer optional for ABA practices that want predictable revenue.

CPT codes 97157 and 97158 often look simple on paper, but in real-world ABA practices, they are some of the most misunderstood and misused applied behavior analysis CPT codes.

How to Use 97157 and 97158 in ABA Therapy

Both 97157 and 97158 fall under applied behavior analysis CPT codes and are designed for caregiver involvement. However, they serve very different clinical purposes. To better understand ABA CPT codes, explore this complete overview here

97157 CPT Code Description

CPT code 97157 is used for family adaptive behavior treatment guidance. This code applies when a qualified ABA provider works directly with a caregiver or parent to teach them how to support treatment goals outside of direct therapy time.

How to Use CPT Code 97157 Correctly

Use CPT 97157 when the session is focused on caregiver coaching and support, such as:

• Reviewing behavior data and progress, then translating it into home strategies

• Teaching caregivers how to respond to problem behaviors using the treatment plan

• Practicing reinforcement schedules, prompting steps, or prevention strategies

• Troubleshooting real-life situations like transitions, meal routines, or community outings

• Updating caregiver procedures after treatment plan changes

This ABA therapy CPT code should read like guidance and training, not direct client treatment. If the note shows the provider is working with the client instead of coaching the caregiver, the claim won’t match the intent of 97157.

97158 CPT Code Description

CPT code 97158 is used for group adaptive behavior treatment guidance. It applies when multiple caregivers or support individuals are trained together, again without the client present. This is often referred to as the 97158 ABA code for group caregiver training.

How CPT Code 97158 Is Typically Used

Use 97158 when caregiver guidance happens in a group setting, such as:

• A caregiver training workshop for multiple families working on similar goals

• Group instruction on reinforcement systems, antecedent strategies, or behavior supports

• Coaching several caregivers to implement consistent routines across settings

• Teaching crisis prevention, de-escalation steps, or safety response plans as a group

• Running a structured parent group focused on generalization and carryover

This is one of the ABA CPT codes that works well for caregiver education, but it must be documented as structured group guidance. Notes should capture the topic, who attended, what was taught, and how the training supports treatment goals.

Used correctly, these CPT codes help build consistency across home and community settings while keeping billing clean and defensible.

When to Use CPT Codes 97157 vs 97158 in ABA Billing

Understanding when to use CPT codes 97157 vs 97158 comes down to one core question: who is in the room, and what is the provider doing? 

Both codes fall under applied behavior analysis CPT codes, but they serve very different clinical and billing purposes.

Use CPT code 97157 when the service is caregiver-focused, and the client is not present. This ABA therapy CPT code applies to face-to-face sessions where a BCBA educates, trains, or guides parents, guardians, or caregivers. These sessions often include reviewing behavior data, discussing triggers and reinforcement strategies, and refining the treatment plan. Because the client is absent, caregivers tend to speak more openly, which strengthens clinical decision-making. As with most ABA billing codes, 97157 is billed in 15-minute units and typically capped at six units per day.

Use CPT 97158 when direct treatment is delivered to multiple clients in a group setting. This 97158 CPT code is used for structured group services like social skills training, where the provider actively prompts, models, and reinforces behavior. Group size, active participation, and clear documentation are critical when using CPT codes ABA.

Using the wrong code is one of the most common causes of denials during audits. Clear documentation and correct code selection protect revenue and keep care moving forward.

If you’re converting or cross-checking codes, use this ABA code conversion table to avoid errors.

Important Things to Know Before Applying These Codes

• Documentation is Key: For CPT 97157, document which caregivers were present and the specific skills taught. For CPT 97158, document the specific protocol modifications made for each patient in the group. Read more about ABA session notes with the examples.

• Group Size Limits: Most payers follow the AMA guideline of 2–8 participants for group codes. Check your specific contract.

• Medical Necessity Must Be Clear: Payers expect justification for caregiver involvement. Documentation should link the session directly to treatment goals and client outcomes. Without that connection, even correctly coded claims may be denied.

• Avoid Double Billing: You cannot bill 97157, 97158, and a direct treatment code for the same provider at the same time. This is a frequent compliance issue flagged during audits of ABA therapy CPT code usage.

• Authorization Rules Vary: Some payers require prior authorization for CPT 97157 and CPT 97158, while others bundle them into treatment plans. Always verify benefits before billing.

Practices that verify authorization upfront reduce denial rates by up to 30 percent.

FAQ

1. What is the 97158 CPT code description?

The 97158 CPT code describes caregiver training provided with the client present, where skills are practiced together under a BCBA’s direction and documented clearly.

2. Can 97154 and 97158 be billed together?

Sometimes, yes. They can be billed on the same day if services are separate, time does not overlap, and documentation supports both services clearly.

3. Can we use 97157 for parent training groups?

No. 97157 is for caregiver guidance without the client present. Group parent training does not meet the intent of this code.

Conclusion

Understanding how and when to use CPT codes 97157 and 97158 in ABA therapy isn’t about memorizing definitions. It’s about aligning clinical intent, documentation, and billing accuracy.

If your practice is unsure whether you’re applying 97157, 97158, or other ABA billing codes correctly, it’s time to review your workflows.

If you’d like expert guidance, book a call to review your ABA billing processes and ensure everything is on track.