New York Medicaid cuts the technician ABA rate to $9.63 per unit for CPT 97153, effective October 1, 2026

The August 2026 issue of the New York State Medicaid Update, Volume 42, Number 9, carries an article titled Reimbursement Change for Unlicensed Individuals Providing Applied Behavior Analysis Services. It says that, as authorized by the enacted budget for state fiscal year 2026 to 2027, New York Medicaid fee for service will decrease the fee paid for ABA services provided by unlicensed individuals and technicians, represented by CPT code 97153, and that effective October 1, 2026 the reimbursement for 97153 will be reduced to $9.63 per unit. The article gives no percentage and no prior rate, names no modifiers, and does not address Medicaid managed care. It points providers to the eMedNY ABA page for the fee schedule.

The eMedNY ABA fee schedule, which carries an effective date of October 1, 2026, lists 97153 at $9.63 per unit. It lists $19.26 for 97151, 97152, 97155 and 97156, and $3.31 per unit per member for the group codes 97154, 97157 and 97158.

The August 2025 issue of the Medicaid Update, Volume 41, Number 8, set the earlier steps for 97153: $16.85 per unit effective October 1, 2025, and $14.45 per unit effective April 1, 2026. It states no percentages. Measured against the $19.26 that the current fee schedule lists for other codes, those are 87.5%, 75% and now 50%, so $9.63 is half of $19.26. At four 15 minute units an hour it is $38.52 an hour, against about $77 an hour at $19.26. These percentages are our arithmetic, not statements in either Update. Measured from $14.45, the October 1 step alone is about one third.

The August 2025 Update also required, effective October 1, 2025, that licensed behavior analysts supervise unlicensed individuals and technicians for a minimum of five percent of the hours the technician spends providing services each calendar month. Supervision must include at least two face to face, real time contacts a month, with the analyst observing the technician in at least one of them, and it must be documented in the patient file. The Update says the supervision standard also applies to Medicaid managed care providers.

WRVO Public Media reported on October 5, 2026 that New York cut Medicaid reimbursement for one to one technician ABA by 50%, which it described as half of what the program paid in early 2025, and, citing the Council of Autism Service Providers, called the lowest public Medicaid rate for one to one ABA in the country. The council asked the governor's office, lawmakers and the Medicaid director to reconsider. The story reported no state response. FingerLakes1 reported on October 2, 2026, citing Times Union reporting, that the hourly payment fell from about $77 to $38 according to an industry representative, and that state officials said the payment tiers reflect differences in training and experience.

The notice addresses fee for service only, and we do not know how Medicaid managed care plans price 97153. The state documents state no percentages, so every percentage here is our arithmetic. We have not read the Times Union article.