CPT Code 97151: Behavior identification assessment

When to Use CPT 97151

Use CPT code 97151 when billing for behavior identification assessment. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 97151 to a Superbill

When generating a superbill with CPT 97151, include the ICD-10 diagnosis code, date of service, fee charged, amount paid, and your NPI number. Superbilled pre-fills common therapy CPT codes automatically.

Common ICD-10 Pairings

These diagnosis codes are frequently used alongside CPT 97151:

Documentation Requirements

Document the functional behavior assessment, target behaviors identified, and proposed treatment plan. Must be administered by a qualified behavior analyst (BCBA).

Common Denial Reasons

• ✗ Assessment not performed by a BCBA or qualified provider
• ✗ Missing functional behavior assessment documentation
• ✗ Prior authorization not obtained when required by the plan

Reimbursement Expectations

OON reimbursement for ABA varies widely by payer. Expect 40-60% of UCR, typically $60-$180.