Louisiana’s Medicaid ABA fee schedule has not moved since July 2022, holding technician therapy at the bottom of its regional band. A 2025 increase lifted physician pay to 85 percent of Medicare and left autism therapy rates untouched.
Key Takeaways
- The ABA fee schedule has been frozen since July 1, 2022: Louisiana’s published Applied Behavior Analysis fee schedule still carries its 2022 effective date, holding the technician code (97153) at $12.50 and the analyst code (97155) at $22.50 per 15-minute unit. The state refreshed its ABA coverage manual in August 2025, but the rates did not change.
- Louisiana’s technician rate sits at the bottom of its regional band: At $12.50 per 15-minute unit, the state’s 97153 rate is the lowest in its regional set apart from Alabama, according to MediRate. A 2022 Senate resolution had already placed Louisiana’s line-technician rate in the lower 20 percent nationally.
- A 2025 rate increase lifted physician pay but not ABA: Effective July 1, 2025, Louisiana raised Medicaid reimbursement to 85 percent of Medicare for physicians and four related clinician types, a $258.4 million investment. Behavior analysts were not on that list, and the ABA schedule stayed at its 2022 levels.
- Access barriers compound the rate question: A 2022 legislative resolution described families waiting six to twelve months for an autism diagnosis and another six to twelve months to begin therapy, and provider waitlists remain common. Whether Louisiana revisits ABA pay as it works toward its stated goal of 100 percent of Medicare by 2028 is the open question for providers and families.
The document that sets what Louisiana Medicaid pays for autism therapy carries a single, telling date: effective for dates of service on or after July 1, 2022. More than four years later, that schedule is still the one in force. The rates a provider can bill for Applied Behavior Analysis in Louisiana today are the rates the state set in the summer of 2022, unchanged through a period in which labor costs, rent, and the price of nearly everything else a clinic pays for have climbed.
That stasis is the story. Louisiana has not cut its ABA rates, which sets it apart from the wave of states that reduced autism therapy payments in 2025 and 2026. But it has not raised them either, and a closer look at the fee schedule, the legislative record, and a separate 2025 rate increase that reached most of Medicaid shows a benefit that has been left in place while the ground shifted around it.
What Louisiana Pays, and How It Compares
Louisiana reimburses technician-delivered therapy (CPT 97153) at $12.50 per 15-minute unit, which works out to $50 an hour before any managed care adjustment. Among the state’s bordering and near-neighbor states, only Alabama, an outlier at $10.00, pays less. Texas ($14.50), Arkansas ($15.00), Mississippi ($15.08), and Oklahoma ($17.35) all sit above Louisiana. The unweighted average across this six-state group is about $14.07, and Louisiana falls more than a dollar below it.
State Rate Comparison: Medicaid ABA Reimbursement, CPT 97153 (Adaptive Behavior Treatment by Protocol), per 15-minute unit. Source: MediRate.
On the analyst code (CPT 97155), Louisiana pays $22.50 per 15-minute unit, tied with Arkansas for the lowest in the regional set once Alabama’s $15.00 is set aside. Louisiana’s schedule also reimburses the same service at different amounts based on the credential of the person delivering it, with a lower TF (intermediate) tier. Several states tier the same way (Texas among them), and the comparison here uses each state’s higher-credential rate throughout for consistency. For the granular, code-by-code detail across the full ABA set, MediRate maintains the underlying datasets.
State Rate Comparison: Medicaid ABA Reimbursement, CPT 97155 (Adaptive Behavior Treatment with Protocol Modification), per 15-minute unit. Source: MediRate.
A Legislature That Already Asked for More
The case for higher Louisiana ABA rates is not new, and it did not come from providers alone. In 2022, the same year the current schedule took effect, the Legislature passed Senate Concurrent Resolution 28, formally urging the Louisiana Department of Health and commercial insurers to raise reimbursement for autism therapy. The resolution laid out the problem in unusual detail. It noted that since the Medicaid ABA program began in 2014, reimbursement for some services had fallen by as much as 24 percent, even as costs rose. It observed that Louisiana’s rate for a registered line technician without a college degree ranked in the lower 20 percent of all states. And it flagged the access consequence: families routinely wait six to twelve months for a diagnosis, then another six to twelve months to start therapy, delays that make treatment longer and more intensive when it finally begins.
The resolution asked the health department to adjust the Medicaid budget to fund more equitable ABA rates. It carried no force of law, and in the years since, the fee schedule has not changed.
The 2025 Increase That Went to Physicians
Louisiana did raise Medicaid rates, substantially, in 2025. Effective July 1 of that year, the health department increased reimbursement to 85 percent of the March 2024 Medicare rates, a change authorized by Act 306 of 2024 and funded through the 2025 budget at a cost of $258.4 million for the fiscal year. The department described it as one of the most comprehensive rate increases in a decade, and state leaders set a goal of reaching 100 percent of Medicare by fiscal year 2028.
The increase applied to physicians, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives, and it was pegged to Medicare’s fee schedule. ABA does not sit neatly in that framework. Behavior analysts were not among the listed provider types the increase covered, and the ABA fee schedule was not part of the change. The practical result is that the biggest Louisiana Medicaid rate action in years moved physician pay while the ABA schedule stayed exactly where it was in 2022. Louisiana is not alone in holding autism rates flat: Massachusetts moved to keep its ABA reimbursement flat through 2026, and Oregon left its ABA rates unchanged for the year, though Oregon’s analyst rate sits far higher than Louisiana’s.
How Families Actually Reach ABA in Louisiana
Louisiana delivers ABA through managed care. Coverage runs to beneficiaries under 21 through the state’s five Healthy Louisiana plans (Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, and Louisiana Healthcare Connections), each of which prior authorizes services. Before therapy can begin, a child needs a Comprehensive Diagnostic Evaluation from a qualified health care professional, and services must be delivered by or under the supervision of a behavior analyst licensed by the Louisiana Behavior Analyst Board. Authorizations run in periods of no more than 180 days, with reassessment at least every six months.
The state updated this rulebook in an August 2025 reissue of Chapter 4 of its Medicaid Services Manual, updating and clarifying coverage requirements. That the rules were refreshed while the rates were not is the sharpest way to see the freeze: Louisiana revised how ABA works without revising what it pays.
A National Backdrop of Cuts, Freezes, and Scrutiny
Louisiana’s stability looks different depending on the comparison. Set against states that have actively cut, it is a reprieve. New York phased in a 25 percent reduction to its technician-delivered ABA rate; Indiana moved through a multi-year rate phasedown alongside new caps and supervision rules; and in Georgia, CareSource cut its Medicaid ABA rates by 20 percent. Across the region, Louisiana’s floor is low but not the lowest: Alabama has held the Southeast’s rate floor for years. And the risk is not only about rate levels. In Oklahoma, an ABA provider nearly missed payroll after the state suspended its SoonerCare payments over a fraud allegation before a judge ordered them resumed, a reminder that payment stability and program integrity now travel together.
For Louisiana providers, the practical question is whether the state’s march toward 100 percent of Medicare eventually pulls ABA into the conversation, or whether a benefit that sits outside that Medicare-pegged framework stays outside it. For families already waiting a year or more to start therapy, the rate that determines whether a clinic can staff a case is not an abstraction. It is the difference between an open slot and a waitlist.
Frequently Asked Questions
Does Louisiana Medicaid cover ABA therapy?
Yes. Louisiana covers ABA for Medicaid beneficiaries under 21 through its five managed care plans, following a Comprehensive Diagnostic Evaluation and prior authorization.
What are Louisiana’s current Medicaid ABA rates?
The state pays $12.50 per 15-minute unit for technician-delivered therapy (97153) and $22.50 for analyst-delivered protocol modification (97155). Both have been in effect since July 1, 2022.
Did the 2025 Louisiana Medicaid rate increase raise ABA rates?
No. The July 2025 increase to 85 percent of Medicare applied to physicians, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives. The ABA fee schedule was not changed.
How do families access ABA in Louisiana?
A child is first evaluated by a qualified health care professional through a Comprehensive Diagnostic Evaluation, then chooses an ABA provider in their managed care plan’s network, subject to plan approval.
