How have Aba Medicaid Rates Changed in 2026?
For 2026, several state Medicaid programs are projecting modest reductions in reimbursement rates for ABA therapy, specifically for CPT code 97153 (adaptive behavior treatment by a technician). These adjustments are driven by state budget cycles, legislative actions, and cost-containment measures rather than changes in the clinical value of the services.
The projected changes for key service areas include:
- Arizona: A projected 3.6% reduction in the average Medicaid rate, decreasing from approximately $14.00 per unit in 2025 to $13.50 per unit in 2026.
- Utah: A projected 2% decrease, moving from $12.50 per unit in 2025 to $12.25 per unit in 2026.
- Maryland: A projected 1.8% decrease, shifting from $13.75 per unit in 2025 to $13.50 per unit in 2026.
While these public payer rates are shifting, private insurance rates typically remain more stable for the duration of a plan year, though they are subject to individual network contract negotiations. Families are encouraged to perform insurance verification to understand how these updates impact their specific out-of-pocket costs and access to care.
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