Authored by ASP-RCM Solutions Team · Last updated: May 31, 2026
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The ABA Operator

Medicaid ABA rate cuts, BCBA credentialing slowdowns, and the parent A/R problem.

Issue #1May 2026By the ASP-RCM Team5 min read

Welcome to the first issue of The ABA Operator. We put this together for ABA chain owners, COOs, and clinical directors. Each month we cover three things happening in the industry that affect your practice, what they mean operationally, and one thing we're working on at ASP-RCM. About 5 minutes.

If this isn't useful to you, just reply with "unsubscribe" and we'll take you off the list the same day. If you have questions, replying gets you a real person on our team.

01Six states are quietly cutting Medicaid ABA rates.

Six states have announced ABA rate reductions for FY2026. Three of those reductions are over 8 percent. Tennessee dropped 97155 rates by 12 percent. Indiana moved 97153 reauthorizations to annual instead of every 6 months (which sounds easier, but the new rules also tighten unit caps). Florida added a stricter 6-month re-evaluation requirement that's already showing up in payer denials.

What this means operationally. Your Medicaid revenue per BCBA hour is dropping while your compliance burden is rising. If you haven't audited your top 3 Medicaid plans since January, you're worth doing now. Look for rate changes, new authorization unit caps, and pre-cert documentation requirements. Across the practices we audit, this is usually a 4 to 8 percent revenue leak that's invisible until someone checks.

Our team is putting together a state-by-state ABA Medicaid rate tracker for next week. Free, no email required to view it. Email us if you'd like a copy.

02BCBA credentialing is now a 102-day average.

APBA's 2025 workforce report shows BCBA hiring demand up 18 percent year over year, but credentialing time has stretched from 75 days to 102 days on average. The math is rough: every BCBA hire costs roughly 14 weeks of lost billable hours, which works out to $46K to $77K per hire in revenue that never gets billed.

What this means operationally. The bottleneck has moved from recruiting to credentialing. Three things that help based on what we see work for our clients:
  1. Start CAQH the day you make an offer, not the day they sign.
  2. Run state Medicaid in parallel with commercial payers. Sequencing them costs you weeks.
  3. Re-check enrollment status monthly for every BCBA. Payers sometimes terminate enrollments silently when recerts get missed.

Our BCBA credentialing average is currently 22 days. The difference between us and the industry average isn't anything clever, just process discipline and starting earlier.

03Parent A/R is at 58 days and getting worse.

A new CASP survey of 187 ABA practices (March 2026) shows parent A/R days outstanding jumped from 41 to 58 days year over year. The drivers are inflation pressure on families and confusing EOBs after January deductible resets. About 23 percent of practices wrote off more than $50K in parent A/R in Q1 alone.

What this means operationally. The fix usually isn't more aggressive collections. It's clearer statements and better VOB before treatment starts. When parents understand their deductible and copay obligation before the first appointment, post-treatment collection rates jump 35 to 50 percent.

Quick test: pull your 10 oldest parent A/R balances. Look at whether the VOB at intake correctly identified the family's financial responsibility. In most of the audits we run, 7 out of 10 didn't.

What's new at ASP-RCM

  • Credential OS v2.4 shipped this week. The new release auto-fills state Medicaid applications for CA, FL, TX, NY, MD, and NJ. For clients we're already credentialing, this cuts our turnaround from 28 days to 19 days on average.
  • Our free ABA Denial Audit has been refreshed. It's a 4-minute interactive tool that returns your estimated annual leakage by CPT, a peer benchmark by practice size, and your top 3 recoverable opportunities. No email required, no demo wrapped around it. Try it here.
  • CASP Annual Convention, Las Vegas, Sept 10 to 13. Our team will be there. Reply if you'd like to grab coffee.

One thing worth 30 minutes this week

If you haven't done a structured RCM audit of your practice, this is a good month for it. We run a free 30-minute call. No slides, no pitch. You bring your last 90 days of denial codes, your AR aging report, and your BCBA roster, and we'll walk you through where the leaks are. The audit is useful whether you hire us or not.

Bring your numbers. We'll bring the benchmarks.

A free 30-minute call with someone senior on our team. No sales deck, no SDR. You leave with a 4-page audit memo you can use.

Book a call Try the free audit first
The ASP-RCM Team
ASP-RCM Solutions · CASP Business Affiliate · Inc. 5000
asprcmsolutions.com · 469-393-0083

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