“Devastating”: New York Slashes ABA Reimbursement For The Third Time Creating An Existential Threat To Access

ALBANY, NEW YORK – New York’s fee-for-service Medicaid program will reimburse providers $9.63 per 15-minute unit of technician-delivered ABA under CPT 97153 beginning October 1, a 33% cut from the current $14.45 and the third reduction in 12 months, according to DOH’s August 2026 Medicaid Update, which NYSABA said was released on Sep 16, 2026. Until October 2025, the rate was $19.26. The new one is exactly half of that.

The code being cut, CPT 97153, pays for the hours behavior technicians spend one-on-one with children carrying out a licensed analyst’s treatment plan. The number is not new. Governor Kathy Hochul’s first attempt, in her budget for the fiscal year that began in April 2025, was a 50% cut to the rate for services delivered by unlicensed technicians. By February 2025, the Council of Autism Service Providers (CASP) had put the resulting figure, $9.63, before lawmakers, warning that it “would become the lowest rate in the country and would decimate provider networks.” The final 2025 budget reduced the original cut to approximately 25%, phased in through two reductions each equivalent to 12.5% of the original rate, implemented in October 2025 and April 2026. After the third cut, the rate will be the one the 2025 budget proposed.

How the 50% Cut Came Back

In 2025, the state defended the figure as fair pay in line with other states. Health Commissioner James McDonald told legislators at a February 11, 2025, hearing that the reduced rate was “still a fair wage” and that “this is what most other states have done,” CBS New York reported. Hochul’s office told the station the proposal “will not impact a single licensed provider” and would “hopefully encourage unlicensed providers to go through … critical training necessary to be qualified.” The Health Department’s notice this month makes a related argument in one sentence: the change “ensures providers of ABA services are compensated equitably for their training and experience.” It is the identical sentence the department used for the first two cuts, and the notice offers no other explanation.

The third cut was on paper before the second had taken effect. Hochul’s budget proposal for fiscal 2027, released in January 2026, projected savings from “Applied Behavioral Analysis Reforms” starting October 1, 2026: $13.7 million of the state’s share of Medicaid costs in FY2027 and $30.9 million in FY2028. The New York State Association for Behavior Analysis (NYSABA) told lawmakers in February 2026 that the reform plan it had taken to the administration the previous October had drawn “a one-paragraph proposal” and a further rate cut, which the Governor’s briefing book described as adjusting “reimbursement methodologies so that ABA providers are compensated equitably with their experience.” The enacted budget retained an ABA reimbursement cut, and Hochul signed the budget May 28. The executive-budget scorecard listed projected savings; the September DOH notice specified the $9.63 rate.

$38.52 an Hour, Against Other States

Four billable units would generate $38.52 in provider reimbursement per treatment hour, down from $77.04 before the cuts. This payment must support service-delivery costs; it is not the technician’s hourly wage.

Providers told lawmakers in February 2026 that even $14.45 would sit below the national average. CASP said in a February 6 letter to the Senate health committee that the rate was 13.7% below its benchmark drawn from publicly available Medicaid rates; $9.63 is a third lower still. Autism Learning Partners (ALP), which reported 352 employees in New York, told the February 10 joint budget hearing that the April cut would push New York below Texas and “well below Massachusetts, New Jersey, Maryland, and California’s rates.” The company said it decided to leave Texas in April because rates there were “too low to sustain operations.”

Intake Closures and a Freeze on New Medicaid Providers

ALP stopped taking new Medicaid and Child Health Plus patients across New York on April 17, citing the cuts. In that announcement, ALP reported serving 523 children in the state, including 480 Medicaid or Child Health Plus members, with 118 children waiting. Child Health Plus is New York’s children’s health insurance program. The company estimated that closing intake eliminated planned capacity for approximately 425 additional children during 2026. “These reductions come at the exact moment when New York families are finally gaining access to autism services through Medicaid,” Gina Chang, the company’s president and chief executive, said in April. ALP’s New York executive director, Rachael Schneider, described the cuts’ effects on access and care quality as “devastating.” Before the April cut, CASP and NYSABA reported that roughly three-quarters of respondents to their joint provider survey anticipated potentially leaving Medicaid. Their February testimony gave slightly different figures: 73% and 74%, respectively. These were reported expectations, not a count of actual departures. NYSABA said then that some providers had already suspended services.

New York has paused new Medicaid enrollment for ABA providers, including pending applications. Already-enrolled providers are not barred from continuing to participate. On July 30 the state’s Medicaid director, Amir Bassiri, froze new provider enrollment for at least 6 months in 6 categories, ABA among them, while the state puts in place a federally required process for re-checking every enrolled provider’s credentials.

NYSABA, in a statement dated September 17, said the reforms it and CASP had proposed over the past year “were ignored.” “While other states have chosen alternative paths to reforming their Medicaid ABA benefit, it is unfortunate that New York has chosen to move in a very precarious direction,” the group said.

The notice applies to fee-for-service Medicaid and does not say whether or when managed care plans will adopt the rate. The freeze on new providers runs at least into late January.

AT A GLANCE

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