The Current State of ABA Telehealth Coverage

The COVID-19 public health emergency introduced temporary telehealth flexibilities that allowed ABA services to be delivered via video for the first time under many insurance plans. As of 2026, most of these flexibilities have been made permanent — but the specific rules vary significantly by payor and service type.

What's Covered via Telehealth (Most Payors)

The following ABA services are covered via telehealth by most major commercial payors and many state Medicaid programs:

  • 97151 — Behavior identification assessment (BCBA-delivered)
  • 97155 — Adaptive behavior treatment with protocol modification (BCBA direct therapy)
  • 97156 — Family adaptive behavior treatment guidance (parent training)
  • 97157 — Multiple-family group adaptive behavior treatment guidance

    • What's NOT Covered via Telehealth (Most Payors)

    The following services are generally not covered via telehealth:

  • 97152 — Behavior identification supporting assessment (requires in-person observation)
  • 97153 — Adaptive behavior treatment by protocol (RBT-delivered direct therapy)
  • 97154 — Group adaptive behavior treatment by protocol

    • The rationale: technician-delivered direct therapy (97153) requires physical presence to implement behavior intervention procedures safely and effectively. Most payors have not extended telehealth coverage to technician-delivered services.

    Commercial Payor Telehealth Policies

    Payor97151971559715697153
    Aetna✓ Covered✓ Covered✓ Covered✗ Not covered
    Anthem✓ Covered✓ Covered✓ Covered✗ Not covered
    Cigna✓ Covered✓ Covered✓ Covered✗ Not covered
    UHC/Optum✓ Covered✓ Covered✓ Covered✗ Not covered
    Humana✓ Covered✓ Covered✓ Covered✗ Not covered

    Billing Telehealth Correctly

    Place of Service Codes

  • POS 02 — Telehealth provided other than in patient's home
  • POS 10 — Telehealth provided in patient's home (most ABA telehealth)

    • Use POS 10 when the client is at home during the telehealth session. Use POS 02 when the client is at a location other than their home (e.g., a school or community center).

    Modifiers

  • Add modifier 95 to the CPT code for most commercial payors
  • Add modifier GT for payors that still require the legacy telehealth modifier
  • Do not use both 95 and GT on the same claim line

    • Documentation Requirements

    Telehealth session notes must include:

  • Confirmation that the session was conducted via synchronous audio/video
  • The platform used (must be HIPAA-compliant)
  • The client's location during the session
  • Confirmation that the client consented to telehealth services

    • State Medicaid Telehealth Coverage

    State Medicaid telehealth policies for ABA vary significantly. As of 2026:

    States with broad ABA telehealth coverage (including 97155 and 97156):

    Florida, Texas, California, New York, Ohio, Georgia, North Carolina, Michigan

    States with limited ABA telehealth coverage (97156 only or assessment codes only):

    Alabama, Mississippi, Montana, Wyoming, South Dakota

    States where ABA telehealth policy is under active review:

    Hawaii, Idaho, North Dakota

    Always verify current telehealth coverage with the specific state Medicaid program before billing telehealth services.