What does New York Medicaid pay for ABA code 97153?

As of Oct. 1, 2026, New York's fee-for-service Medicaid fee schedule pays $9.63 per 15-minute unit for CPT 97153, adaptive behavior treatment delivered by a technician. That works out to $38.52 an hour. It was $14.45 from April 1, 2026 and $16.85 from Oct. 1, 2025.

Did New York cut every ABA code?

No. The fee schedule effective Oct. 1, 2026 still pays $19.26 per unit for assessment (97151, 97152), protocol modification (97155) and family guidance (97156). Group codes pay $3.31 per unit per member. The Oct. 1 notice changed only the technician-delivered code, 97153.

Why did New York cut the ABA technician rate?

The Department of Health's notice says the cut is authorized by the state's enacted budget for fiscal year 2026-2027 and applies to services by unlicensed individuals or technicians billed under 97153. Provider groups have asked the governor's office and the Medicaid director to reconsider.

New York: ABA technician rate cut to $9.63 Oct. 1

New York Medicaid cut its fee for technician-delivered ABA, CPT 97153, to $9.63 per 15-minute unit on Oct. 1, its third cut in a year. Providers say the rate is now the lowest in the country; in Georgia, the Medicaid plan for foster children cut ABA pay 30% on Sept. 1.

policy · new-york · medicaid · rates · autism · aba

Quintin Soloviev, Wikimedia Commons, CC BY 4.0

Direct Support News desk · October 5, 2026 · 2 min read

New York's Medicaid program now pays $9.63 per 15-minute unit, or $38.52 an hour, when a behavior technician delivers applied behavior analysis (ABA) under CPT code 97153. The rate took effect Oct. 1, 2026, under a notice in the Department of Health's August 2026 Medicaid Update, reported on Sept. 23 by Behavioral Health Business; WRVO reported on Oct. 5 on providers' response.

Three cuts in a year

Effective date	97153 rate per 15-minute unit	Source
Oct. 1, 2025	$16.85	NYS Medicaid Update, Aug. 2025
April 1, 2026	$14.45	NYS Medicaid Update, Aug. 2025
Oct. 1, 2026	$9.63	NYS Medicaid Update, Aug. 2026

Rates as of Oct. 5, 2026. The latest step is a 33% cut from $14.45, and Behavioral Health Business and the Council of Autism Service Providers put the total cut at 50% from early 2025. The department's fee schedule effective Oct. 1 still pays $19.26 a unit for assessment, protocol modification by a qualified professional and family guidance, so the cut lands only on direct one-to-one hours delivered by technicians. The notice says the budget for fiscal year 2026-2027 authorizes the change. It covers fee-for-service Medicaid and does not set a date for managed care plans.

Provider response

The Council of Autism Service Providers said at a briefing last week that the rate leaves New York with the lowest publicly available Medicaid rate for one-to-one ABA in the country, WRVO reported. Behavioral Health Business, citing MediRate data, said the previous lowest was West Virginia at $9.90. The council is asking Gov. Kathy Hochul's office and Medicaid Director Amir Bassiri to reconsider. A department spokesperson told Behavioral Health Business the state remains committed to access to medically necessary care while managing Medicaid resources.

Georgia: 30% cut for foster children

The Georgia Recorder reported on Oct. 5 that Amerigroup, the only Medicaid plan serving Georgia's foster children, cut ABA payments by 30% from Sept. 1 while raising rates for parent training. State Rep. Lee Hawkins said industry surveys found 75% of clinics expect to reduce or stop serving foster children within three months at the new rate.

Why this matters for providers and DSPs

Many I/DD provider agencies run behavior services, and technician wages are paid out of the 97153 rate. Providers quoted by WRVO and Behavioral Health Business warn of staff cuts, dropped Medicaid patients and closed programs. When clinic ABA shrinks, more of the day-to-day work of carrying out a behavior support plan falls to families, teachers and DSPs in homes and day programs. Agencies billing New York managed care plans should check their contracts for when, and whether, each plan follows the new rate.

Common questions

What does New York Medicaid pay for ABA code 97153?: As of Oct. 1, 2026, New York's fee-for-service Medicaid fee schedule pays $9.63 per 15-minute unit for CPT 97153, adaptive behavior treatment delivered by a technician. That works out to $38.52 an hour. It was $14.45 from April 1, 2026 and $16.85 from Oct. 1, 2025.
Did New York cut every ABA code?: No. The fee schedule effective Oct. 1, 2026 still pays $19.26 per unit for assessment (97151, 97152), protocol modification (97155) and family guidance (97156). Group codes pay $3.31 per unit per member. The Oct. 1 notice changed only the technician-delivered code, 97153.
Why did New York cut the ABA technician rate?: The Department of Health's notice says the cut is authorized by the state's enacted budget for fiscal year 2026-2027 and applies to services by unlicensed individuals or technicians billed under 97153. Provider groups have asked the governor's office and the Medicaid director to reconsider.