How much is an ABA client worth? Hours, rates and tenure, by program type

A working model for the lifetime revenue of one enrolled ABA client, by program type, and what it means for how much you can spend to add one.

Matisyahu Friedman

Founder, Lukrah

Most ABA providers we talk to have never written down what one enrolled client is worth. They know the hourly rate and they know the authorization, but the number that should drive every marketing decision, the lifetime gross revenue of one child who starts services this month, usually lives in nobody's head. This post is the model we use. Swap in your own figures; the structure is the point.

## The three inputs

Lifetime revenue per client comes from three numbers, and two of them are already in your billing system.

**Authorized hours per week.** This is set by the treatment plan and the payer. Comprehensive programs run 25 to 40 hours a week, almost always center-based or a center and home mix. Focused programs run 10 to 15 hours, often in-home. Most multi-center providers carry a blend that averages around 20.

**Blended rate per hour.** Technician time (CPT 97153) bills at roughly $50 to $75 an hour depending on the state and payer, and BCBA supervision (97155, 97156) bills higher but at a much lower share of hours. Across a typical case, the blended rate lands between $55 and $75 an hour. Medicaid-heavy states sit at the low end; commercial-heavy states at the high end.

**Tenure.** How long the client stays. Industry-typical is 18 to 30 months, driven by age at start, progress, payer re-authorization and whether the family moves or ages out of early intervention. Two years is a defensible planning figure. If your retention is better, use yours; it changes the answer more than anything else.

## The math, by program type

Forty-eight billable weeks a year accounts for holidays, cancellations and the gaps between authorizations.

| Program type | Hours per week | Revenue per year | Lifetime at ~2 years |
|---|---|---|---|
| Focused, in-home | 10 to 15 | $35k to $50k | $70k to $100k |
| Comprehensive, center-based | 25 to 35 | $75k to $110k | $150k to $220k |
| Blended average, 20 hours | 20 | $60k to $75k | $120k to $150k |

Those are gross revenue, not margin. Technician wages, supervision, benefits, rent and the cost of carrying authorizations that don't get fully used all come out of it. But gross is the right number for the acquisition decision, because that is what a new client adds to the top line and what your cost per enrollment is measured against.

We plan to $75,000 per client on every ABA account. It's deliberately low. It assumes a blended program, a conservative rate and a shorter tenure than most providers actually see, so that when the real number comes in higher, the marketing budget is already justified.

## What it means for acquisition spend

Once you have the lifetime figure, the question "how much can we spend on marketing" has an answer instead of a feeling.

Our target on every account is all-in marketing, retainer plus ad spend, at under 10% of the lifetime revenue it produces. At $75,000 per client, that's a ceiling of $7,500 per enrollment. In practice, a well-run paid and organic program lands between $1,000 and $4,000 per enrolled client, which is 1.5% to 5% of lifetime revenue.

Put the other way: a provider spending $9,500 a month all-in (a $3,500 retainer plus $6,000 in Google Ads) needs to enroll roughly one client every eight weeks for the marketing to pay for itself, and three a month puts it at about 4% of lifetime revenue. That's the whole case for marketing in ABA. The lifetime value is so large relative to the cost of one more enrollment that the only way to lose is to spend on inquiries that never get a call back.

## Where the model breaks

Three things make the real number worse than the table, and all three are intake problems, not marketing problems.

**Out-of-network families.** If a third of your inquiries are families you can't take, your cost per enrollment is effectively 50% higher than your cost per qualified inquiry suggests. The fix is a form that asks the payer first and ads that state which insurers you accept in the headline.

**Slow response.** A family who submits a form at 7:40pm and hears back at 10 the next morning has usually already booked an intake assessment with someone else. Every hour of delay costs enrollments, and no amount of ad spend buys them back.

**No diagnosis yet.** A large share of parents searching for ABA don't have the diagnosis the payer requires. If you offer evaluations and your pages don't say so, those families leave. If you don't offer them, a referral path keeps the family warm until they do.

## Use your own numbers

Pull three things from your billing system: average authorized hours per active client, blended collected rate per hour, and median tenure for clients discharged in the last two years. Multiply. Then ask your current agency, or your own spreadsheet, what you paid per enrolled client last quarter. If the second number is under 10% of the first and you know it by center, you're in good shape. If nobody can tell you the second number at all, that's the problem to fix before spending another dollar on ads.