Your Medicaid ABA Billing Is Public, by NPI and Month. Reporters Are Using It.
HHS's provider-level Medicaid spending file covers 2018 to 2024, managed care included. The 74 built a private equity investigation on it, and a House committee wants it made permanent.
What Medicaid paid your practice for ABA from 2018 through 2024 is now in a public file, broken out by billing NPI, servicing NPI, procedure code and month. HHS posted it on February 9, 2026. In September it stopped being a curiosity: The 74 built a national investigation of private equity in ABA on it (September 15), Minnesota Public Radio followed (September 23), and on September 29 the House Energy and Commerce Committee's majority staff asked Congress to "codify the HHS Open Data Platform" that hosts it.
We covered CMS's state-level ABA heat map in September. That compared states. This file compares providers, and it doesn't need anyone's permission to do it.
What's in it
- Coverage: fee-for-service, managed care encounters and CHIP, January 2018 to December 2024. HHS calls 2024 "preliminary and subject to change."
- Each row: billing NPI, servicing NPI, HCPCS code, month, unique patients, claim lines and total paid. There are no units, so hours can't be read straight off it, but dollars by code can.
- Suppression: a row appears only with at least 12 claim lines and at least 12 beneficiaries. A small practice can be partly or wholly invisible; a large one isn't.
What reporters did with it
The 74 found Medicaid claims on the main ABA codes rose about 381%, from roughly $400 million a year in 2019 to nearly $2 billion in 2024, that private equity owns 11 of the 15 largest billers, and that Centria billed more than $440 million over the six years. We ran the 97151–97158 codes from the same file and got $444.1 million in 2019 and $2.12 billion in 2024, with the largest single billing NPI at $433 million across 2019–2024. That matches.
The limits
CPT 9715x is only part of Medicaid ABA. CMS's own heat map, added up across the states, puts calendar 2025 ABA payments near $12 billion, because many states pay ABA under their own codes. HHS warns that cross-state differences "may reflect state-specific Medicaid policies, coding practices ... or data submission patterns." An NPI is often a corporate office, not a clinic. A row is a lead, not a finding. That's how the file will be used anyway.
What you must know or do
- Owners: pull your own rows. Download the file at opendata.hhs.gov (the CSV is 11.5 GB; filter on your billing NPI) and check that the totals match your 2023–2024 remittances. A mismatch is something to understand before someone else asks about it.
- Owners and billing leads: divide your paid 97155 dollars by your paid 97153 dollars, month by month. That's the supervision ratio a payer, auditor or reporter can now compute without asking you. Payers recoup on it: see Meridian's 10-for-1.
- Clinical directors: check which NPI sits in the servicing field on your claims. If it's your BCBAs', their individual monthly volume is in this file, and the NPI Registry puts a name to each one.
- Owners pitching referral sources or legislators: if you're independent, the file shows exactly where you sit next to the large billers in your state. That's now a public comparison, and you can use it.