Oregon’s behavioral health fee schedule left ABA rates unchanged for 2026, keeping the 97155 analyst rate at $32.07, among the highest in the Western states.
Key Takeaways
- Oregon’s behavioral health fee schedule, reissued effective February 1, 2026, left every applied behavior analysis code unchanged from its November 2025 rates. The technician code 97153 holds at $14.70 per 15-minute unit and the analyst code 97155 at $32.07.
- Those rates place Oregon at or near the top of the regional range. They run well above Washington’s $12.40 and $14.09 for the same two codes, according to MediRate.
- Oregon delivers Medicaid through Coordinated Care Organizations, so the state fee schedule functions as a floor. At least one major CCO reimburses ABA at 100 percent of the state schedule even as it trims other behavioral health rates.
- With no rate change to react to, the live questions for Oregon providers center on who may bill directly, prior authorization, and how the CCO structure shapes the payment a provider actually collects.
Oregon did something in 2026 that has become unusual: nothing. When the Oregon Health Authority (OHA) reissued its behavioral health fee schedule effective February 1, 2026 (published February 6), the applied behavior analysis rates came through untouched, identical line for line to the November 2025 version. The reissue updated other parts of the combined behavioral health schedule; the ABA codes were not among them.
That stability is itself the story. A number of state Medicaid programs have moved to cut ABA payments, add prior authorization, or absorb the therapy into tighter managed care budgets. States including North Carolina, Nebraska, Colorado, and Indiana have pursued reductions or new authorization hurdles, and the resulting strain has fed behavioral health layoffs across the sector. Oregon, by contrast, held its technician rate at $14.70 per 15-minute unit (97153) and its analyst rate at $32.07 (97155).
Those figures place Oregon at the top of the regional range and more than double Washington’s analyst rate for the identical code. For a field where the binding constraint is often the supply of credentialed analysts, holding a relatively high analyst rate is a quiet competitive signal, even in a year with no headline policy change to announce.
Under Oregon’s rules, ABA for autism spectrum disorder must be recommended by a licensed practitioner experienced in diagnosing and treating the condition, and a client’s progress is measured through standardized assessments at intake and again every six months. The benefit is built around documented medical necessity, which shapes both authorization and the kind of provider that can carry a case, and it explains why the rate paid for analyst assessment and modification work matters as much as the headline treatment rate.
What Oregon’s 2026 Behavioral Health Fee Schedule Pays for ABA
Oregon’s schedule is notable for how flat it is across provider type. The state pays $20.85 per unit for the assessment code 97151 and $19.81 for 97152, $14.70 for technician treatment (97153), and $32.07 for analyst protocol modification (97155). It pays that same $32.07 for family guidance delivered by a qualified professional (97156). Within a given code, the rate does not change with the rendering provider’s credential, so the published figure is the figure regardless of who in the care team delivers the unit.
Authorization follows a split familiar to ABA billers. The treatment codes require prior authorization, while the initial assessment (97151) is handled through retrospective review, with authorization materials routed through the state’s utilization-management contractor. Oregon also permits a telehealth modifier on its ABA codes, allowing qualifying services to be delivered by interactive audiovisual technology where clinically appropriate. None of these mechanics changed for 2026, which is precisely why the year reads as a structural story rather than a rate story.
Set against its neighbors, Oregon anchors the high end of the technician band.
Medicaid 97153 (adaptive behavior treatment by a technician), maximum allowable rate per 15-minute unit: Oregon and selected Western states. Source: MediRate.
On 97153, MediRate’s comparison puts Oregon at $14.70, at the top of the technician band, ahead of Washington’s $12.40 and Montana’s $11.36. The spread on the technician code is narrow across the region; the real divergence shows up on the analyst code, where even Nevada’s climb to $30.10 still trails Oregon, and where Utah’s new permanent rate mechanism reflects how some states are trying to defend analyst pay against future cuts.
How Coordinated Care Organizations Shape Oregon ABA Payment
Oregon delivers most of its Medicaid program through Coordinated Care Organizations, regional entities that manage care under global budgets. That structure matters for how to read the fee schedule: the published rate is a floor, and what a provider actually collects can depend on the CCO and its contract terms. A high state rate does not guarantee a high realized rate, but it sets the baseline that plans must meet.
Medicaid 97155 (adaptive behavior treatment with protocol modification, analyst-delivered), maximum allowable rate per 15-minute unit: Oregon and selected Western states. Source: MediRate.
For ABA, that floor has so far held. CareOregon, one of the largest CCO networks, has told providers that for 2026 it will reimburse ABA and substance use disorder residential services at 100 percent of OHA’s fee schedule, even as it moves other outpatient behavioral health groups to 90 percent of state rates or onto a tiered, team-based payment framework. In effect, Oregon has carved ABA out of the belt-tightening it is applying elsewhere in behavioral health, which helps explain why the analyst rate in the chart above stands so far above Washington’s $14.09. The contrast also frames a regional caution: large neighbors are still in motion, including California’s pending rate-setting SPA, so today’s rankings may not hold all year.
The practical upshot for operators is that Oregon’s attractiveness rests less on any single number than on the combination of a high floor and a payer that has chosen to protect it. That is a different competitive proposition than a state leading with a managed-care carve-in or a fresh coverage policy, as Florida did in 2026, and it rewards providers who can document medical necessity and ride out authorization cycles rather than chase rate arbitrage.
The mechanism behind that protection is Oregon’s Qualified Directed Payment framework, which CareOregon is restructuring for 2026 by renaming its provider tiers and tying enhanced payments to team-based, high-acuity criteria. ABA and substance use disorder residential services are explicitly excluded from those new team-based criteria, but rather than being penalized, they are held at the full state rate. The carve-out is deliberate, and it tells providers that Oregon views ABA as a service to shield from rate pressure rather than a line to trim.
Who Can Bill Oregon Medicaid Directly for ABA
Oregon limits direct Medicaid payment to a defined set of providers. Under the state’s administrative rules, a Licensed Behavior Analyst, certain registered licensed health care professionals, and individuals holding a declaration of practice may bill directly. Assistant Behavior Analysts and Behavior Analysis Interventionists are not eligible for direct payment, even though they deliver care under supervision. For multi-state operators, that is a meaningful structural difference from states that enroll assistant-level or technician-level providers as billing entities.
The licensing framework traces back to 2013, when Oregon mandated insurance coverage of ABA and created its Behavior Analysis Regulatory Board along with a title act for licensed behavior analysts and licensed assistant behavior analysts, and a registration for behavior analysis interventionists. That board now governs who may practice and, by extension, who can be paid, which keeps Oregon’s direct-payment pool comparatively narrow and analyst-centered.
In practice, that means an Oregon clinic bills under its analysts while assistant-level and interventionist staff deliver supervised hours the analyst remains accountable for. The model concentrates both clinical responsibility and billing authority in the licensed analyst, which is consistent with a schedule that pays the analyst code at more than double the technician code and helps explain why Oregon’s economics reward depth of analyst staffing over technician volume alone.
One adjacent development is worth watching but easy to overread. A 2025 measure, Senate Bill 609, directs OHA and CCOs to set minimum reimbursement amounts for primary care, dental, optometry, and behavioral health beginning in 2026, pending federal approval. As written, it defines a behavioral health provider by reference to the licensing chapter that covers psychologists, counselors, and social workers, not behavior analysts, so ABA appears to sit outside its rate floor. The more concrete pressures on Oregon ABA economics are the same ones the field is debating nationally: prior authorization, and the long-running argument over treatment hours and intensity, rather than any cut to the headline rate. For 2026, Oregon’s ABA story is one of stability held deliberately while neighbors move.
