New York Cuts 97153 to $9.63 on Thursday. That's Half the April 2023 Rate.

The August Medicaid Update, posted September 18, reduces fee-for-service reimbursement for technician-delivered ABA to $9.63 a unit from October 1. Fee-for-service only — the Update says nothing about managed care, where most New York ABA volume sits.

From the New York State Medicaid Update, August 2026, Volume 42 Number 9, posted on September 18:

“Effective October 1, 2026, the reimbursement for CPT code ‘97153’ will be reduced to $9.63/per unit.”

The posted eMedNY fee schedule still reads $14.45, dated April 1, 2026. It has not been updated for the cut.

The arithmetic

  • April 2023: $19.26
  • October 2025: $16.85
  • April 2026: $14.45
  • October 1, 2026: $9.63

That is 33.4% off the current rate and exactly 50% off April 2023. In hourly terms, technician-delivered treatment goes to $38.52 an hour while 97155 stays at $77.04.

The turn: the stated reason doesn't fit the code it spared

The Update gives a rationale: the change “ensures providers of ABA services are compensated equitably for their training and experience.”

97152 — behavior identification supporting assessment — is also delivered by a technician under the direction of a qualified health care professional. It stays at $19.26. The same person's time is worth $19.26 under one code and $9.63 under another, and the training-and-experience explanation does not distinguish them. Nothing in the Update addresses it.

The limits, and this one decides whether it reaches you

The Update speaks only to fee-for-service. ABA was carved into the Medicaid managed care benefit package on January 1, 2023, and most New York ABA volume is managed care. This is not a blanket New York rate cut, and reporting it as one would be wrong.

What it is: the state's own fee benchmark, moved by the enacted FY 2026-27 budget. Plans that peg to the FFS schedule, or that renegotiate against it, now have a number half what it was two and a half years ago. Washington chose the fee schedule for exactly that reach earlier this year. New York has not said whether it intends the same.

What you must know or do

  • Split your New York book by payer before Thursday and total the 97153 units that bill fee-for-service. Multiply by $4.82. That is the monthly revenue change, and for most practices it will be smaller than the headline suggests.
  • Ask every managed care plan in writing whether it is following the FFS reduction, and by when. Get the answer on paper now, while the plan is deciding, rather than discovering it in a remittance.
  • Reconcile October remits against $9.63, not against the posted schedule. eMedNY still shows $14.45; the Update governs.
  • If your MCO contract references the state fee schedule, find that clause this week. A peg you never negotiated is how a fee-for-service cut becomes a managed care cut without an amendment.