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ABA Medicaid rate tracker, Q4 2026 into 2027

Short answer: seven states, dated ABA fee-schedule actions for Q4 2026 and early 2027: three cuts or rebases, two holds, one increase, one updated schedule.
NY 97153 · $9.63 IN 97153 U1 · $15.39 FFS floors

October 27, 20266 min readASP-RCM Solutions

Edition
Q4 · 2026
States
7
Cuts or rebases
3
Holds
2
Next dated cut
Apr 1, 2027
Refresh
On each state action
$9.63
New York technician 97153, from October 1, 2026 [3]
$15.39
Indiana 97153 U1 from April 1, 2027 [1]
3states
Indiana, New York, Nebraska
2holds
Massachusetts (proposed), Montana [7] [8]
How to read it

Seven states, four actions; MCO policy in the payer matrix

Reduction or rebase

  • Indiana, New York, Nebraska

Hold

  • Massachusetts (proposed), Montana

Increase

  • North Dakota

Updated schedule

  • Washington
The tracker

Rate actions by state

StateActionRate detailDates of service
Indiana [1]Phased reduction6% on nongroup ABA codes, then 4% more on all ABA codes; 97153 U1 $17.06 to $16.04 to $15.39; 97155 U3 $27.63 to $25.97 to $24.93; new group tiers by sizeApr 1, 2026 Apr 1, 2027
New York [3] [4]Single-code reduction97153 by unlicensed individuals or technicians to $9.63 per unit, FY 2026-27 Enacted Budget. SPA 25-0061 carries October 1, 2025; reconcile remits to the Medicaid Update date and keep both on fileOn or after Oct 1, 2026
Nebraska [5]Schedule rebaseBlended average of nearby states' Medicaid ABA rates; same for governmental and private providers; per-code amounts on the DHHS schedule, none estimated hereAug 1, 2025 CMS approved Aug 6, 2026
Washington [6]Updated schedule97151 $18.79 (28 units per assessment, two per year); 97153 $12.40 with PA; 97155 $14.09; 97156 $18.32; H2020 day program $571.30 per diemJul 1, 2026
Massachusetts [7]Hold (proposed)101 CMR 358.00 rates maintained for 197 providers; no change in aggregate spending; subject to federal approvalOn or after Dec 1, 2026
Montana [8]HoldNo SFY 2027 provider rate adjustments except by statute or federal rule; 2026 RBRVS RVUs applied budget neutralSFY 2027
North Dakota [9]IncreaseAutism Spectrum Disorder services under EPSDT, estimated $70,000 increase over 12 monthsJul 1, 2026
One unit, three states

97153, per unit

FFS rate per technician unit of 97153 [1] [6] [3]

$17.06baseline
Indianabefore Apr 2026
$16.04-6.0%
Indianafrom Apr 1, 2026
$15.39-9.8% vs base
Indianafrom Apr 1, 2027
$12.40with PA
Washingtonfrom Jul 1, 2026
$9.6356% of IN base
New Yorkfrom Oct 1, 2026
Pre-cut baselineIndiana phasesWashingtonNew York
Rules beside the rates

Rules that decide whether the unit is paid

StateRuleEffective
Indiana [2]Complete FBA for each behavior targeted by a behavior intervention plan, updated at each reauthorizationOct 29, 2026
Indiana [1]EPSDT only: nothing at 21 and older; 4,000-hour lifetime comprehensive allocation, UA; credential modifiers U1, U2, U3; no modifier 95 on 97151 to 97154 or 0373TOct 1, 2026 age Apr 1, 2026 rest
North Carolina [10]Paraprofessionals need RBT or ABAT certification, 120-day grace; no telehealth for 97152 to 97154; plans above 16 hours a week reauthorized every three months; 10% LQASP observationAug 1, 2026 grace to late Nov
Missouri [11]Exact start and stop times; sum minutes per code per day; convert once with the 8-minute table; one line per code per day or it denies as a duplicateSep 9, 2026
Georgia [12]Dates of service on or after July 1, 2026 from providers who did not revalidate are not paid; new effective date is the submission date, no retro-enrollmentJul 1, 2026
The ABA billing calendar

Six dates, October 2026 to April 2027

  1. 1
    Oct 1, 2026NY 97153 technician $9.63; IN under-21 limit
  2. 2
    Oct 29, 2026IN FBA for every BIP target
  3. 3
    Late Nov 2026NC certification grace ends
  4. 4
    Dec 1, 2026MA 101 CMR 358.00, proposed unchanged
  5. 5
    Jan 1, 2027CMS-0057-F Prior Authorization API
  6. 6
    Apr 1, 2027IN second-phase 4% cut, all ABA codes
Takeaway

The schedule sets the price; the bulletins beside it decide whether the unit is paid. Load both, dated.

What to do this week

Each row, one action

Load every rate with its date of serviceBefore the first claim.
Reconcile the first remits after each dateWritten notices to MCOs paying below contract.
Turn each rule row into a scrubber editModifiers, telehealth by code, credential status, one line per code per day.
Rebuild the 2027 budget on delivered unitsMargin playbook; gross collection rate guide.
FAQ

Frequently asked questions

Which states cut ABA Medicaid rates for late 2026 and 2027?

Indiana: 6% from April 1, 2026, 4% more from April 1, 2027. New York: technician 97153 to $9.63 from October 1, 2026. Nebraska: rebased to nearby states' average from August 1, 2025.

Which states are holding ABA rates flat?

Massachusetts: 101 CMR 358.00 rates proposed unchanged from December 1, 2026, pending federal approval. Montana: no SFY 2027 adjustments beyond statute.

Do these fee schedules apply to Medicaid managed care plans?

No; they are fee-for-service schedules. MCOs pay under contract unless the state sets a floor; confirm the MCO rate in the contract.

What is the Washington Apple Health rate for 97153 in 2026?

From July 1, 2026: 97153 $12.40 with prior authorization; 97155 $14.09; 97156 $18.32; 97151 $18.79, 28 units per assessment, two a year.

Sources
  1. Indiana IHCP bulletin BT202627, IHCP announces changes to applied behavior analysis (ABA) therapy services (February 26, 2026)
  2. Indiana IHCP bulletin BT2026162, IHCP requires functional behavior assessments for ABA therapy and behavior intervention plan (September 29, 2026)
  3. New York State Medicaid Update, August 2026, Volume 42 Number 9: Reimbursement Change for Unlicensed Individuals Providing Applied Behavior Analysis Services
  4. New York State Department of Health, SPA 25-0061 transmittal to CMS, Applied Behavior Analysis (December 31, 2025)
  5. Medicaid.gov, Nebraska State Plan Amendment NE-25-0020, Applied Behavioral Analysis rates (approved August 6, 2026)
  6. Washington State Health Care Authority, Apple Health ABA fee schedule effective July 1, 2026
  7. Massachusetts EOHHS, Notice of Public Hearing, 101 CMR 358.00 Rates for Applied Behavior Analysis (hearing June 17, 2026)
  8. Montana DPHHS provider notice, State Fiscal Year 2027 Provider Rate Update (May 29, 2026)
  9. North Dakota HHS, Public notice of Medicaid state plan changes effective July 1, 2026
  10. NC Medicaid bulletin, Updated reminder: requirements for Research-Based Behavioral Health Treatment service delivery (August 31, 2026)
  11. MO HealthNet hot tip, Important Information for Documenting and Billing for Applied Behavior Analysis Services (September 9, 2026)
  12. Georgia Department of Community Health, Provider Revalidation Deadline July 1, 2026

Checked October 27, 2026. Confirm against the source; proposed rules are marked proposed.

Related
ABA billing services ABA payer policy matrix by state ABA Medicaid rate cuts 2027 margin playbook ABA gross collection rate explained The ABA Operator: year-end sweep ABA RCM toolkit

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