Protocol modification
CPT 97158 — Group adaptive behavior treatment with protocol modification
Group adaptive behavior treatment with protocol modification, administered by a physician or other qualified health care professional, billed in 15-minute units, for two or more patients.
- Billed by
- A BCBA or other QHP modifying protocols in a group setting.
- Unit structure
- Time-based, billed in 15-minute units, for a group of two or more clients.
- Patient present
- Face-to-face, in a group setting with two or more patients.
What it covers
The service behind the code.
- Protocol modification for individual clients within a group format
- Real-time clinical decision-making based on each client's data
- Directing group treatment while adjusting protocols
Documentation requirements
What the note has to show.
- A separate note in each client's record showing their specific modification
- What was modified for that client and the clinical rationale
- How that client responded to the modified protocol
- Start and end times supporting the units billed
Denials & downcoding
Why 97158 claims get rejected.
- One shared note instead of an individual note per client
- Notes with no documented modification — reads like group treatment (97154)
- Modifications described without clinical rationale
Clinically reviewed by BxScribe Clinical Team
BxScribe's clinical content is reviewed against current BACB ethics and documentation standards, CPT code descriptors, and common commercial and Medicaid payer requirements before publication. Last reviewed May 1, 2026. This page is educational and does not replace your payer contract or clinical judgment.
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Related codes
Codes often billed alongside 97158.
Glossary
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