Two ABA practices with identical schedules can earn very different revenue, because what you're paid per unit depends entirely on your payer mix and your contracted rates. This dashboard shows where revenue actually comes from — by payer and by CPT code — and how much each unit of care really realizes after the payer is done.
Why payer mix and reimbursement matter
ABA reimbursement varies widely: commercial, Medicaid, and TRICARE pay different rates, and within each, the four core CPT codes — 97151 (assessment), 97153 (RBT direct), 97155 (BCBA), 97156 (parent training) — reimburse differently per 15-minute unit. A practice heavily concentrated in one low-rate payer is both lower-margin and higher-risk: a single contract change can swing the business. Knowing the mix is the first step to managing both.
What this dashboard tracks
The overview shows total paid, total billed, total units, and the blended average reimbursement per unit — the rate you actually realize across everything. Revenue by payer shows concentration and the mix; average reimbursement per unit by CPT code shows which services carry the rate; and a payer-share view makes concentration risk obvious. Billed-vs-paid by payer hints at which contracts underpay relative to charges.
How to read it
Start with payer concentration — if one payer drives most of your revenue, that's your single biggest contract risk. Then read reimbursement per unit by payer and CPT: large gaps are negotiation leverage or a signal to shift mix. The blended per-unit rate is the number to watch over time; if it drifts down, either the mix is shifting toward lower-rate payers or rates are eroding.
How it differs from the revenue cycle report
The revenue-cycle dashboard answers "did we collect what we billed" (denials, AR, net collection). This one answers "who pays us, and how much per unit of care" — the mix and rate side of revenue, where contract and growth decisions get made.
Who uses it
Billing and RCM leaders use it to spot underpaying contracts and concentration risk; owners and finance use it for contract negotiation and to steer the payer mix toward healthier margins.
Metrics it tracks
| Metric | What it means |
|---|---|
| Total Paid | Total payments received across all payers in the period. |
| Total Units | 15-minute service units billed. |
| Average Reimbursement Per Unit | Total paid ÷ total units — the blended rate you actually realize. |
| Total Billed | Total charges submitted across all payers. |
Used by: Billing/RCM leaders, owners, finance
Frequently asked questions
What is payer mix and why does it matter for an ABA practice?
Payer mix is the share of your revenue coming from each payer (commercial, Medicaid, TRICARE, etc.). It matters because rates differ sharply by payer, so the mix sets your blended margin — and heavy concentration in one payer is a major risk if that contract changes.
How does reimbursement differ across ABA CPT codes?
The four core codes reimburse differently per 15-minute unit: 97151 (assessment) and 97155 (BCBA protocol modification) typically carry higher per-unit rates than 97153 (RBT direct therapy), with 97156 (parent training) in between. Exact rates depend on the payer and contract.
What is payer concentration risk?
It's the exposure created when a large share of revenue depends on a single payer. If that payer cuts rates, changes authorization rules, or drops you, the impact is outsized. Tracking payer share is how a practice sees and manages that risk.
Can I build this on my own remittance data?
Yes. Export your paid-claims/remittance data by payer and CPT and use this as a template — we model it into a Power BI report. The sample uses synthetic data, so there's no PHI here.
Build this report on your own data
Clone this ABA template — describe it and we’ll generate sample data so you can try it free, or upload your own export. You get a fully modeled, branded Power BI project that opens in Power BI Desktop.
Use this as a template →