CPT Code 97153: Adaptive behavior treatment, direct patient contact

When to Use CPT 97153

Use CPT code 97153 when billing for adaptive behavior treatment, direct patient contact. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 97153 to a Superbill

When generating a superbill with CPT 97153, 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 97153:

Documentation Requirements

Document target behaviors addressed, interventions used, and patient response during the direct therapy session. Include data collection on behavior targets.

Common Denial Reasons

• ✗ Authorized hours exceeded for the service period
• ✗ Treatment plan not updated or goals not measurable
• ✗ Session note lacks behavior data or objective measures

Reimbursement Expectations

OON reimbursement typically 40-60% of UCR. Expect $32-$90 per hour of direct therapy.