Every ABA Medicaid rate cut, hour cap and billing change, with sources.
State-by-state Medicaid rates for 97153 and 97155, plus a dated log of 2025-26 cuts, caps, billing rules and pending bills. Every number links to the document it came from, and if we haven't confirmed a number, we say so.
Find your state Report a managed-care rateLatest changes
Newest first. Full change log →
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97153 cut 33% to $9.63/unit
Third cut in a year: technician direct therapy (97153) drops from $14.45 to $9.63 per 15 min ($38.52/hr) for Medicaid fee-for-service, a cumulative ~50% cut from $19.26. Authorized by the FY2026-27 enacted budget. Other ABA codes stay at $19.26.
Source: NYS Medicaid Update, Aug 2026 (Vol. 42 No. 9) · Verified: official source · checked Oct 20, 2026 -
ABA ends for Medicaid members 21+
IHCP no longer authorizes or reimburses ABA for members 21 and older for dates of service on/after Oct 1, 2026, after a 6-month transition window (Apr 1 - Sep 30, 2026). ABA is now covered only through EPSDT.
Source: IHCP Bulletin BT202627 (Feb 26, 2026) · Verified: official source · checked Oct 20, 2026 -
ABA moves from tiered case rate to fee-for-service
DVHA stops reimbursing the tiered monthly case rate; all ABA billed fee-for-service. Expected to be budget neutral. The state said it will not reverse the concurrent-billing ban.
Source: Vermont GCR 26-058 (final) · Verified: official source · checked Oct 20, 2026 -
Extrapolated overpayment audits authorized (HB26-1412)
For audits started after July 1, 2026, HCPF may recover pediatric behavioral therapy overpayments (2022-23 services; 2024-25 if a pattern is found) using statistical sampling and extrapolation.
Source: Colorado General Assembly: HB26-1412 · Verified: official source · checked Oct 20, 2026 -
CareSource: ABA paid at 80% of fee schedule (partly rescinded July)
Managed care plan CareSource notified ABA providers (Mar 27) of a 20% cut effective May 11, 2026. In July it rescinded the cut for some providers in shortage areas only; others who refused were dropped from network.
Source: WRDW News 12, Jul 22, 2026 · Reported: news source · checked Oct 20, 2026 -
HB 696 signed (Session Law 2026-1)
Medicaid oversight law signed by the Governor Apr 30, 2026. Trade press reports it includes ABA rules such as in-person assessment requirements, a 50% telehealth supervision cap and a minimum supervision floor; read the ratified text for exact provisions.
Source: NC General Assembly: H696 / SL 2026-1 · Verified: official source · checked Oct 20, 2026
Coming up & pending
Scheduled changes, bills and proposals to watch.
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Scheduled: additional 4% cut to all ABA codes
Further 4% max-fee cut including group codes (97153 -> $15.39; 97155 U3 -> $24.93).
Source: IHCP Bulletin BT202627 (Feb 26, 2026) · Verified: official source · checked Oct 20, 2026 -
Proposed: cut ABA rate benchmark from 100% to 95% of comparable states
Legislative staff estimated ~$2.7M general-fund savings by paying 95% of the comparable-state average. Status not yet confirmed.
Source: Colorado Association of Health Plans (news repost) · Reported: news source · checked Oct 20, 2026 -
A03896: 680-hour annual cap on ABA insurance coverage
Would cap insurance coverage for ABA (and DIR/Floortime) at 680 hours per person per year (~13 hrs/week). Bill trackers show it referred to the Assembly Insurance Committee on Jan 7, 2026 with no later action; the official page timed out on our check date, so status is not yet re-confirmed.
Source: NY Senate: Assembly Bill A3896 (2025-26) · Reported: news source · checked Oct 20, 2026
All 50 states + DC
Tap a state for rates, its change log, what it means and sources.
| State | 97153 / 15 min | 97155 / 15 min | Changes | Latest dated item |
|---|---|---|---|---|
| Alabama | not yet verified | not yet verified | - | - |
| Alaska | $22.63 | $29.78 | - | - |
| Arizona | $17.91 | $25.05 | - | - |
| Arkansas | not yet verified | not yet verified | - | - |
| California | not yet verified | not yet verified | - | - |
| Colorado | not yet verified | not yet verified | 3 | Jul 1, 2026 |
| Connecticut | not yet verified | not yet verified | - | - |
| Delaware | $15.68 | $17.66 | - | - |
| District of Columbia | not yet verified | not yet verified | - | - |
| Florida | $12.26 | $19.17 | - | - |
| Georgia | not yet verified | not yet verified | 1 | May 11, 2026 |
| Hawaii | not yet verified | not yet verified | - | - |
| Idaho | not yet verified | not yet verified | 1 | Dec 1, 2025 |
| Illinois | $13.00 | $20.39 | - | - |
| Indiana | $16.04 | $25.97 | 5 | Apr 1, 2027 |
| Iowa | not yet verified | not yet verified | - | - |
| Kansas | not yet verified | not yet verified | - | - |
| Kentucky | not yet verified | not yet verified | - | - |
| Louisiana | not yet verified | not yet verified | - | - |
| Maine | not yet verified | not yet verified | - | - |
| Maryland | $19.17 | $38.34 | - | - |
| Massachusetts | not yet verified | not yet verified | - | - |
| Michigan | $16.50 | not yet verified | - | - |
| Minnesota | not yet verified | not yet verified | - | - |
| Mississippi | not yet verified | not yet verified | - | - |
| Missouri | not yet verified | not yet verified | - | - |
| Montana | $11.36 | $20.46 | - | - |
| Nebraska | $18.70 | $22.72 | 2 | Aug 1, 2025 |
| Nevada | $30.10 | $30.10 | - | - |
| New Hampshire | not yet verified | not yet verified | - | - |
| New Jersey | not yet verified | not yet verified | - | - |
| New Mexico | not yet verified | not yet verified | - | - |
| New York | $9.63 | $19.26 | 4 | Oct 1, 2026 |
| North Carolina | $20.81 news | $32.22 news | 3 | Apr 30, 2026 |
| North Dakota | $10.60 | $31.14 | - | - |
| Ohio | not yet verified | not yet verified | - | - |
| Oklahoma | $17.35 | $23.55 | - | - |
| Oregon | $14.70 | $32.07 | - | - |
| Pennsylvania | not yet verified | not yet verified | - | - |
| Rhode Island | not yet verified | not yet verified | - | - |
| South Carolina | $14.88 | not yet verified | - | - |
| South Dakota | not yet verified | not yet verified | - | - |
| Tennessee | not yet verified | not yet verified | - | - |
| Texas | $14.50 | $25.10 | - | - |
| Utah | not yet verified | not yet verified | - | - |
| Vermont | not yet verified | not yet verified | 2 | Jul 1, 2026 |
| Virginia | $15.00 | $46.63 | - | - |
| Washington | $12.40 | $14.09 | 1 | Jan 1, 2026 |
| West Virginia | not yet verified | not yet verified | - | - |
| Wisconsin | not yet verified | not yet verified | - | - |
| Wyoming | $12.30 | $24.60 | - | - |
Medicaid fee-for-service rates unless noted; many states pay through managed-care plans that negotiate their own rates. 20 states verified from official documents, 1 from news reports, 30 not yet verified. Some rates vary by credential or modifier; see each state page.
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