Which States have the Highest Autism Therapy Reimbursement in 2026?
Among the states analyzed for 2026, Arizona is projected to have the highest average Medicaid reimbursement rate for CPT code 97153 (adaptive behavior treatment), followed closely by Maryland.
According to the 2026 projections for Medicaid fee schedules, the rates per unit are:
- Arizona: Projected average rate of $13.50 per unit (despite a 3.6% reduction from 2025).
- Maryland: Projected average rate of $13.50 per unit (reflecting a 1.8% decrease from 2025).
- Utah: Projected average rate of $12.25 per unit (reflecting a 2% decrease from 2025).
While Arizona and Maryland are projected at the same average rate, Arizona historically started from a higher 2025 baseline ($14.00) compared to Maryland ($13.75).
It is important to note that these figures apply specifically to Medicaid. Private insurance reimbursement rates are negotiated between employer health plans and provider networks and typically offer different, often more flexible, rate structures compared to state-legislated Medicaid budgets.
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