ABA · UnitedHealthcare · Effective December 1, 2026

UHC's December 1 prior auth cuts leave out ABA. Keep requesting authorization for 97151 to 97158.

UnitedHealthcare is removing prior authorization for many services for members under 18 on December 1, 2026. On November 6 it revised the code lists. The commercial list now names only two ABA codes, 0362T and 0373T, and CPT deletes both on January 1, 2027. The core codes 97151 to 97158 are on none of the three lists, so your authorization workflow for them stays as it is.

By ASP-RCM Editorial, Healthcare RCM Practice · Updated November 10, 2026

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Core ABA codes on the list

97151 to 97158 keep their current prior auth rules

ABA codes still on it

0362T and 0373T, commercial plans, members under 18

Dec 1

Reduction takes effect

Lists revised November 6, 2026

Jan 1

0362T and 0373T deleted

Replaced by 97148, +97149, 97159 and +97160

Where each ABA code stands on December 1

From UnitedHealthcare's commercial plan code list, effective December 1, 2026, revised November 6, 2026. Members under 18.

Code	What it covers	On the December 1 list?	What to do
97151	Behavior identification assessment by the BCBA	No	Request authorization as you do today
97152	Supporting assessment by a technician	No	Request authorization as you do today
97153	Adaptive behavior treatment by protocol, technician	No	Request authorization as you do today
97154	Group treatment by protocol, technician	No	Request authorization as you do today
97155	Treatment with protocol modification by the BCBA	No	Request authorization as you do today
97156	Family adaptive behavior treatment guidance	No	Request authorization as you do today
97157	Multiple-family group guidance	No	Request authorization as you do today
97158	Group treatment with protocol modification	No	Request authorization as you do today
0362T	Supporting assessment for severe problem behavior	Yes	Check the member in UHC's tool; the code ends December 31
0373T	Treatment with protocol modification for severe problem behavior	Yes	Check the member in UHC's tool; the code ends December 31

Source: UnitedHealthcare commercial plan code list. The Individual Exchange and Community Plan lists include none of these ten codes.

How we got here

Dates from UnitedHealthcare provider news and code lists, checked November 10, 2026.

Oct 1, 2026
UHC tells providers it will remove prior authorization for select codes for all patients under 18 on December 1, and that it will announce the codes before the program begins.
Nov 1, 2026
UHC publishes the program: nearly two-thirds of prior authorization requirements for select services for patients under 18, with separate code lists for commercial, Individual Exchange and Community Plans.
Nov 6, 2026
UHC updates the lists. The commercial list, marked revised November 6, names 0362T and 0373T and none of 97151 to 97158.
Dec 1, 2026
The reduction takes effect for the codes on the lists. Codes vary by state and plan, so UHC points providers to its Prior Authorization and Notification tool.
Jan 1, 2027
0362T and 0373T are deleted from CPT. Their replacements, 97148, +97149, 97159 and +97160, are new codes, so ask UHC how it will handle authorization for them.

Four things to settle before December 1

Do not stop the 97151 to 97158 requests

If anyone on your team read early reports and planned to drop UHC authorizations for assessments or treatment on December 1, stop that plan. A session billed without a required authorization is one of the hardest denials to recover.

Check the member, not the headline

UHC says code removals vary by state and plan. Look each member up in the Prior Authorization and Notification tool on the UHC Provider Portal, and save the result with the case.

The 0362T and 0373T relief lasts one month

Both codes are deleted on January 1, 2027. Plan the move to 97148, +97149, 97159 and +97160 now, and ask UHC in writing whether the new codes need authorization.

Know which plans are out

Medicare Advantage, Dual Eligible Special Needs Plans, Health Plan of Nevada Medicaid and UMR plans that do not follow the UMR list are excluded from the program altogether.

TAKEAWAY

For almost every UHC ABA session, nothing changes on December 1. The authorization rules you follow today for 97151 to 97158 still apply, including for new assessments and new starts. The only ABA codes in the reduction are the two severe problem behavior codes, and they leave CPT a month later.

Your December 1 check

Tick what your team has already done.

Our UHC authorization requests for 97151 to 97158 continue after December 1Intake and scheduling know that new UHC assessments and starts still need authorization where the plan requires itWe check each UHC member in the Prior Authorization and Notification tool and keep the resultWe know which of our UHC members are on excluded plansWe have asked UHC how authorization works for 97148, +97149, 97159 and +97160 from January 1

0 of 5Any box left open is a place a UHC claim can deny. We can check your UHC authorizations against your claims.Get the free ABA revenue health check

Questions operators ask next

Does UnitedHealthcare still require prior authorization for ABA after December 1, 2026?

For 97151 to 97158, the December 1 reduction does not change anything: none of them is on UHC's revised commercial, Individual Exchange or Community Plan code lists. Follow the member's plan rules as you do today, and confirm each member in UHC's Prior Authorization and Notification tool.

Which ABA codes are in UHC's December 1 prior authorization reduction?

Only 0362T and 0373T, on the commercial plan list for members under 18, revised November 6, 2026. Both codes are deleted from CPT on January 1, 2027.

Do Medicare Advantage or Medicaid plans get the December 1 change?

UHC Medicare Advantage plans, Dual Eligible Special Needs Plans, Health Plan of Nevada Medicaid and UMR plans not following the UMR prior authorization list are excluded. Select Community Plans are included, with Nebraska, New Jersey and Tennessee pending state approval when UHC announced the program.

What replaces 0362T and 0373T in 2027?

From January 1, 2027, harmful behavior assessment moves to 97148 with add-on +97149, and harmful behavior treatment moves to 97159 with add-on +97160. Ask UHC in writing how it will handle authorization for the new codes.

Make sure no UHC session goes out without an authorization

Our free ABA revenue health check looks at your authorizations, code mix and payer mix over two years, so you can see where an expired or missing auth is costing you. A senior ABA partner walks your leadership through it.

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Keep reading

ABA billing services 2027 ABA CPT codes: the six new codes and the crosswalk ABA prior authorization, explained Fixing ABA prior authorization denials Free ABA revenue health check

Sources

Checked November 10, 2026. General information on billing operations, not legal advice. UnitedHealthcare decides prior authorization by member, plan and state; confirm each case in its Prior Authorization and Notification tool.