ABA · 2027 CPT · Effective January 1, 2027
Six new ABA codes on January 1. Is your billing partner ready?
The AMA has published the 2027 adaptive behavior code set. Six codes are new, 97151 through 97158 are revised, and two Category III codes are gone. The numbers are simple. The hard part is that the same BCBA hour can now bill two different ways, and each payer decides its own rate and timing.
By ASP-RCM Editorial, Healthcare RCM Practice · Updated
The question we are asking on LinkedIn
On January 1 the same BCBA hour can bill as 97155 or 97173. Who in your organization decides which one, and what will the session note show?
New CPT codes
97148, +97149, 97159, +97160, 97173, 97180
ABA codes in 2027
Up from 10 in the 2019 set
T codes deleted
0362T and 0373T are replaced by Category I codes
Effective date
Payers set their own rates and rollout
Who bills what, before and after
Built from the ABA Coding Coalition conversion table of September 11, 2026.
| The work | Through Dec 31, 2026 | From Jan 1, 2027 | What to watch |
|---|---|---|---|
| BCBA directing a technician, client present | 97155 | 97155 (revised: direction with analysis) | Technician time still on 97153 |
| BCBA treating the client directly | 97155 | 97173 (new) | Rate set by each payer |
| BCBA data review, protocol changes, technician training, no client present | Not separately reportable | 97180 (new) | Coverage is not automatic |
| Harmful behavior assessment, customized setting | 0362T | 97148, plus +97149 for technicians 3 to 5 | QHP on site and immediately available |
| Harmful behavior treatment, customized setting | 0373T | 97159, plus +97160 for technicians 3 to 5 | QHP on site and immediately available |
| Family guidance, group by QHP | 97156, 97157, 97158 | Same numbers, now "with analysis" | Update templates and note language |
Source: ABA Coding Coalition crosswalk and 2027 code list.
Four changes that reach your cash
97155 now means direction
Treating the client directly moves to 97173. The session note has to show which one happened, or the claim has no support.
97180 pays only if you capture it
It may be reported once a week by adding up the prior seven days. Time your BCBAs do not log during the week is gone.
Technician wording changed
97152, 97153 and 97154 no longer say "under the direction of". The crosswalk also drops the line that a QHP may substitute for the technician on 97153, so ask each payer how to report it.
No national Medicare rate
CMS proposed carrier pricing through 2027 for all 14 codes. There is no benchmark to point to, so each rate is a negotiation.
What is settled and what is still open
As of November 4, 2026.
- Sep 2025
The CPT Editorial Panel approves the change, on an application from the ABA Coding Coalition, which then included CASP, and the ABAI commission.
- Jul 14, 2026
The proposed Medicare fee schedule keeps carrier pricing and keeps 97151-97158 on the telehealth list. It does not say whether the six new codes join them.
- Sep 2026
The AMA publishes the 2027 code set. The Coalition publishes the conversion table on September 11.
- November 2026
The Medicare final rule is due. We had not seen it published when this page was written. Check it for telehealth and pricing before you plan on either.
- Dec 31, 2026
Last day for 0362T and 0373T. Any authorization that names them, or 97155, needs an answer from the payer before this date.
- Jan 1, 2027
New codes take effect. Payers follow their own timelines, so expect some to be ready and some not.
A cutover plan you can start this week
Name one owner
One person holds the payer list, the answers and the go-live date for each payer.
Pull your code mix
Twelve months of units by code and payer shows how much money sits on 97155 and the T codes.
Ask every payer in writing
Rates for 97173 and 97180, how open authorizations convert, and the first date they accept each code.
Fix the note and the EMR
Separate direction from direct treatment in the template. Add a weekly log for 97180 time. Confirm the 2027 code table load.
Test, then watch January
Send test claims where you can, and check the add-ons bill with their base codes. Review the first weeks of remits by code.
What a ready billing partner can show you
Not ready
- "We will update the codes in January"
- No answer on open authorizations
- 97180 treated as automatic new revenue
- Same rules assumed for every payer
Ready
- A payer by payer list with rates and dates
- Authorizations spanning January 1 already flagged
- 97180 forecast only where coverage is confirmed
- Claim checks updated for 97155 and 97173 before release
The code numbers are the easy part. Revenue in January depends on the note, the authorization and the payer's answer lining up on the same service.
Are you ready for January 1?
Questions operators ask next
What are the six new ABA CPT codes for 2027?
They are 97148 and +97149 for harmful behavior assessment, 97159 and +97160 for harmful behavior treatment, 97173 for adaptive behavior treatment with analysis by a physician or QHP, and 97180 for non-face-to-face services personally performed by a physician or QHP. All take effect January 1, 2027.
What is the difference between 97155 and 97173 in 2027?
From January 1, 2027, 97155 is direction of a technician with analysis, face-to-face with the client. 97173 is treatment with analysis delivered by the physician or QHP, face-to-face with one client. Direct BCBA treatment that was reported with 97155 moves to 97173, so the note must show what the BCBA did.
Can a BCBA bill for time spent reviewing data in 2027?
97180 covers data review, decisions to modify targets or protocols, assessment planning, discharge planning and technician training, when personally performed by the QHP. It may be reported weekly by adding up the prior seven days. A CPT code does not guarantee coverage, so confirm with each payer.
Do all payers start the new codes on January 1, 2027?
Do not assume it. The Coalition has said that payers follow their own procedures and timelines for new codes, and that providers need that information from each payer. Rates are also set payer by payer, because CMS proposed carrier pricing through 2027. Get each answer in writing.
Find out what January does to your revenue
Our free ABA revenue health check shows your authorizations, code mix and payer mix over two years, so you can see which lines the new codes touch. A senior ABA partner walks your leadership through it.
Keep reading
Sources
- ABA Coding Coalition, 2027 CPT code conversion table and letter, Sep 11, 2026
- ABA Coding Coalition, Billing Codes (2027)
- ABA Coding Coalition, CMS proposed 2027 Medicare Physician Fee Schedule, Jul 15, 2026
- AMA, AMA releases CPT 2027 code set
- ABA Coding Coalition, Frequently Asked Questions
Checked November 4, 2026. General information on billing operations, not legal advice. Rules change; confirm against your state and contracts.