CPT 97155 Note Template and Examples for BCBAs

A CPT 97155 note has to show that a technician was working with the client, that you directed them, and what you concluded from the client’s data, including a decision to change nothing. This page gives a BCBA session note template for 97155 field by field, a filled example and two narrative examples. Every client, name and number in them is fictional.

The template is updated for dates of service from January 1, 2027, when 97155 becomes “direction of technician with analysis” and BCBA 1:1 treatment moves to 97173 (ABA Coding Coalition supplemental guidance, pp. 21-24). For the code itself and when to use 97155 or 97173, see the CPT 97155 guide; for every 2026-to-2027 code change, see the 2027 crosswalk.

Understanding CPT 97155: Adaptive Behavior Treatment with Protocol Modifications

Through December 31, 2026, 97155 is “Adaptive behavior treatment with protocol modification, administered by physician or other qualified healthcare professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes” (2019 descriptor, as printed in the Coalition crosswalk, p. 3). It covered both a BCBA directing an RBT and a BCBA treating the client alone.

From January 1, 2027, 97155 is no longer dual-use. It covers a BCBA or other QHP directing a technician, with analysis, while the technician works face to face with the patient, so it is normally billed alongside a technician code (97148, 97149, 97153, 97154, 97159 or 97160). The ABA Coding Coalition notes one uncommon exception: a QHP directing another QHP who leads a 97158 group. A BCBA treating the patient with no technician bills new code 97173, and 97155 and 97173 are not billed concurrently.

As of October 29, 2026. Sources: ABA Coding Coalition 2027 guidance and the CMS CY 2027 proposed rule. CPT is a registered trademark of the AMA.

For the note, the biggest change is the word “analysis”. The Coalition says an adjustment is not required to bill a code that includes analysis, but the analysis must be “documented clearly in the corresponding session note(s)”, and “if the QHP determines that no adjustments are needed, that decision must be documented” (supplemental guidance, pp. 2 and 22). So the template below has a field for your decision, whatever it is.

When to Use CPT 97155 vs. 97153 and 97156

Pick the code from who was in the room and what you did (2027 dates of service):

• CPT 97153 is the technician’s 1:1 code: “Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient, each 15 minutes” (supplemental guidance, p. 15). The RBT bills it while you bill 97155 for directing them. A BCBA who only stands in for an absent RBT, with no analysis, also bills 97153 (p. 24). For more, see the CPT 97153 guide.
• CPT 97155 is your time directing that technician, face to face with the client, while you analyze the client’s responses.
• CPT 97173 is new: you treat the client yourself, with analysis, and no technician is present (p. 24). It is not billed at the same time as 97155 (p. 31).
• CPT 97156 is caregiver guidance: “including discussing protocols and treatment targets and/or training the caregiver(s) to implement assessment or treatment protocols with the patient”, with or without the patient present (p. 25). If a parent joins the end of a 97155 session for training, that part is a separate service with its own note. See 97155 vs 97156 and the 97156 documentation requirements.
• CPT 97180 is new: your non-face-to-face work, such as reviewing the week’s data or rewriting the written protocol after the session (pp. 10, 22).

Payer-Aligned Documentation Requirements for CPT 97155

Payers differ in the details, so check yours, but every 97155 note should contain these elements:

• Start and stop times: your face-to-face minutes, which set the units.
• Technician and their code: the RBT’s name and credential, and the technician service they delivered during your time (97153, 97154, 97159 and so on). In 2027, 97155 “will ALWAYS be reported with another technician-delivered CPT code”, apart from the uncommon 97158 exception (supplemental guidance, pp. 16 and 28).
• Face-to-face presence: you were with the client and technician, in person or by telehealth if your payer allows it.
• Data reviewed: the probes, trial data or behavior counts you looked at during the session.
• Your analysis and decision: what you concluded, and either the change you made or the reason you kept the protocol. This is the core of 97155 protocol modification documentation.
• Client response: what happened after the change, in numbers.
• Direction provided to the technician: what you modeled, coached or corrected.
• Link to the treatment plan: the goal or target number the session served.
• Location and attendees: setting, and everyone present with their role.
• Signature and credential: the QHP who rendered the service.

If a caregiver joined, note it, but bill caregiver training as 97156 under its own times; it is not part of 97155.

How to Write a Compliant CPT 97155 Note: A Step-by-Step Guide

Follow the fields in order. The example is a fictional supervision session with a young client working on greetings and a replacement behavior for hand-flapping.

1. Basic Session Information

• Date of Service: MM/DD/YYYY
• Client Name and ID: [Name], [ID]
• BCBA Name/Credential: [Your Name, BCBA]
• Technician Name/Credential and code: [RBT’s Name, RBT], 97153
• Start Time / End Time: HH:MM / HH:MM
• Total Units: [Number of units]
• Location: [Home/Clinic/School]
• Attendees: Client, BCBA, RBT [and caregiver, if present]

Fictional example: Date: 02/03/2027; Client: “Alex”, ID AJ-456; BCBA: Jane Doe, BCBA; RBT: Sam Lee, RBT, delivering 97153 2:00-4:00 PM; BCBA time: 2:30-3:30 PM (4 units); Location: home; Attendees: Alex, Jane (BCBA), Sam (RBT).

2. Purpose of Session

One sentence linking the visit to the treatment plan. Example: Direct Sam’s implementation of Goal 2 (peer greetings) and Goal 5 (competing response for hand-flapping); check fidelity and analyze Alex’s data against the plan.

3. Client Presentation & Session Overview

What the client was like and what the technician ran. Example: Alex arrived settled but restless. Sam ran discrete trial training for greetings and natural environment teaching for sharing toys. Two hand-flapping episodes during free play.

4. Data Review & Analysis

The data you looked at and what it showed. Example: Greetings 5/10 independent today, down from 7/10 last week; dips occur when a sibling is in the room. Hand-flapping 5 per hour, mostly in unstructured play. Sam’s fidelity on the greeting protocol 9/10 steps; prompt delay inconsistent.

5. Analysis, Protocol Modifications & Rationale (the core of 97155)

Your decision and the reason, tied to the data and the goal. Write it even if the decision is “no change”. Example: Added a visual cue card to the first three greeting trials, then faded it, because the data shows distraction rather than skill loss. Added a stress-ball squeeze as a competing response at play transitions (Goal 5 target: fewer than 3 per hour). Sharing-toys protocol reviewed: 8/10 independent for three sessions, no change; continue to mastery criterion.

6. Client Response to Modifications

Example: With the visual cue, Alex greeted independently on 4 of the next 5 trials. Two hand-flapping episodes in the following 20 minutes, both interrupted with the stress ball.

7. Direction & Feedback Provided to Technician(s)

Example: Modeled handing over and withdrawing the visual cue on one trial; Sam ran the next four with feedback, 4/4 correct. Practiced the stress-ball prompt with Sam twice. Asked Sam to record prompt level on every trial.

8. Follow-up Outside the Session

Work you will do without the client is not part of 97155. In 2027 the clinical part of it can be 97180, with its own date and times (supplemental guidance, p. 22). Example: Revise the written greeting protocol and data sheet on 02/04/2027 (97180).

9. Plan for Next Session

Example: Probe greetings with the cue faded across two sessions. Sam leads the stress-ball routine. Review the 97180 revision with Sam at the next visit.

Close with your signature and credential.

97155 Narrative Examples: A Passing Note and a Failing Note

Some practices write 97155 as a short narrative instead of fields. These two fictional narratives describe the same session.

Passing (2027 date of service):

02/03/2027, 2:30-3:30 PM, home. BCBA Jane Doe directed RBT Sam Lee (97153, 2:00-4:00 PM) with Alex. Data reviewed: greetings 5/10 independent, down from 7/10; hand-flapping 5/hour in free play; Sam’s fidelity 9/10 steps with inconsistent prompt delay. Analysis: errors follow sibling distraction, not skill loss. Decision: add a visual cue to the first three greeting trials, then fade (Goal 2); add a stress-ball competing response at transitions (Goal 5). Sharing-toys protocol reviewed, no change needed: 8/10 for three sessions. Direction: modeled the cue fade once; Sam ran four trials with feedback, 4/4 correct. Response: 4/5 independent greetings after the change; hand-flapping 2 in 20 minutes. Next: written protocol revision 02/04 (97180); probe with cue faded over two sessions. Jane Doe, BCBA.

Failing:

Observed session with RBT. Adjusted program. Client did well. Will continue plan.

What the failing note is missing, line by line:

• “Observed session with RBT” names no technician, no technician code and no times, so the overlap cannot be checked.
• “Adjusted program” gives no data, no decision and no reason, so there is no analysis on the page.
• “Client did well” has no number and no link to a goal.
• Nothing says what the RBT was told, so the note reads as observation, not direction.

In 2027 a reviewer can’t tell from it whether it was 97155 or 97173, so expect it to be questioned. For what auditors look for, see CPT 97155 audits.

Time/Unit Billing Rules and Common Denial Reasons for CPT 97155

97155 is billed in 15-minute units. The Coalition’s rule for the 2027 codes: “work … lasting 8 - 22 minutes is reportable as one unit. Work lasting less than 8 minutes is not reportable” (supplemental guidance, p. 31). Payers differ on how they count longer sessions, so check your payer’s unit policy. Only your face-to-face time counts; setup and note writing do not (pp. 2, 15).

Common reasons a 97155 claim fails:

• No technician code beside it. From 2027, 97155 describes direction of a technician, so a 97155 line with no 97153, 97154, 97159 or similar for the same time is a mismatch (p. 16). If you treated the client alone, the code is 97173.
• 97155 billed with 97173 or 97152 for the same time. Neither pairing is allowed (pp. 31-32).
• The same QHP billing 97153 and 97155 at once (p. 16).
• Missing analysis. No data, no decision, or “adjusted program” with no detail.
• Generic feedback to the RBT. “Provided guidance” instead of what you modeled or corrected.
• Indirect work billed as 97155. Report writing, graph updates or protocol rewrites done without the client are not 97155; in 2027 the clinical part of that work can be 97180, but writing session notes is not billable (p. 15).
• Units outside the authorization, including 2026 authorizations that have not been converted to the 2027 codes. Ask each payer how it will convert them (Coalition provider guide, p. 2).

Audit-Proof Tips and a Quick QA Checklist for CPT 97155 Documentation

• Be specific. “4/5 independent after the change” beats “good progress”.
• Show the why. Every decision traces to data or a plan goal.
• Make RBT data easy to cite. Data sheets that record prompt level per trial make your analysis field quick to write.
• Write the note soon after the session, while the details are fresh.
• Keep the 97180 work separate, with its own date and times.

CPT 97155 QA Checklist

Before the session

• Authorization covers 97155 (and, from 2027, the technician’s code) for this date?
• Recent data and the treatment plan goals reviewed, so you know what to look for?

In the note

• Client name and ID, BCBA and RBT names and credentials?
• Exact start and stop times and units for your face-to-face time?
• Technician’s code and times for the same period stated?
• Data reviewed during the session named, with numbers?
• Analysis and decision written, including any “no change” decisions?
• Rationale for each change, linked to a goal number?
• Client response to each change?
• Specific direction given to the RBT?
• Location and attendees?
• Signature and credential?

After the session

• Protocol or data-sheet revisions logged as separate 97180 work (2027)?
• Caregiver training, if any, documented as 97156 with its own times?

Frequently Asked Questions

What’s the main difference between 97155 and 97156?

97155 is your time directing a technician who is working with the client. 97156 is your time with the caregivers, discussing protocols or training them to run them with the client, with or without the client present (supplemental guidance, pp. 21, 25). If you start with the RBT and then coach a parent, document and bill the two parts separately.

Can I bill 97155 for indirect supervision or planning time?

No. 97155 is face-to-face with the client and technician. From January 1, 2027, the clinical non-face-to-face work, such as reviewing data or revising a protocol, can be billed as 97180, but writing session notes and general staff training cannot (supplemental guidance, pp. 12 and 15). Before 2027 this time was not separately reportable.

How often should a BCBA perform CPT 97155 supervision?

CPT sets no frequency. The Coalition notes that the CASP guidelines describe an average of 1-2 hours of QHP activity (for example 97155, 97173 and 97180) for every 10 hours of technician treatment, without prescribing any single code (supplemental guidance, p. 11). Payers and the BACB’s RBT supervision rules set their own minimums.

What if the BCBA ran the whole session because the RBT was absent?

If you only stood in for the RBT, bill 97153 (some payers want a modifier). If you treated with analysis, deciding whether targets or protocols needed to change, bill 97173 in 2027 (supplemental guidance, p. 24). Either way it is not 97155, because no technician was there to direct.

What should I do if a payer denies my 97155 claim?

Read the denial reason code first. If it is documentation, compare the note with the QA checklist above and appeal with the session specifics. If it is a code mismatch in 2027 (no technician code, or 97173 on the same time), correct and resubmit.

This page is billing information, not legal advice. Check each payer’s policy before you bill. CPT is a registered trademark of the American Medical Association.

Reviewed by the Praxis Notes team on October 29, 2026.