On January 1, 2027, the ABA code set goes through its biggest change since 2019. Two Category III codes stop working, 97155 narrows to a single use, and six new codes arrive with new documentation rules. Many payers haven’t announced their plans yet.
This guide covers what changed in the 2027 ABA CPT codes, the official crosswalk, and a week-by-week readiness checklist. Code details come from the ABA Coding Coalition. Coverage, rates and authorization rules still vary by payer, so confirm them with each one.
What changed in the 2027 ABA CPT codes?
The AMA CPT Editorial Panel approved a revised adaptive behavior code set in September 2025. The AMA published it with the CPT 2027 code set on September 9, 2026, and the ABA set grows from eight Category I codes and two Category III codes to 14 Category I codes.
Three changes matter most for billing:
- Six new codes cover harmful-behavior assessment and treatment with multiple technicians, one-to-one treatment by a QHP, and non-face-to-face QHP work.
- Codes 97151 through 97158 are revised. The revisions clarify QHP analysis, replacing “protocol modification” in applicable descriptors and adding analysis language to family-guidance codes.
- The temporary Category III codes 0362T and 0373T are deleted and replaced with permanent Category I codes.
QHP means a physician or other qualified health care professional, typically a BCBA.
The 2027 ABA code crosswalk: Old to new
This table follows the ABA Coding Coalition’s crosswalk dated September 11, 2026. Descriptions are paraphrased. Use the CPT 2027 codebook for official descriptor language.
2019 code | 2027 code | Delivered by | What it covers in 2027 |
97151 | 97151 | QHP | Behavior identification assessment, including face-to-face and non-face-to-face time |
97152 | 97152 | Technician | Supporting assessment, face to face |
0362T | 97148 (new) | 2 technicians, QHP on site | Supporting assessment of harmful behavior in a customized environment |
None | +97149 (new) | Each added technician | Add-on to 97148, up to 5 technicians in total |
None | 97180 (new) | QHP | Non-face-to-face work such as data review, protocol decisions and technician training |
97153 | 97153 | Technician | Treatment by protocol, one patient |
0373T | 97159 (new) | 2 technicians, QHP on site | Treatment of harmful behavior in a customized environment |
None | +97160 (new) | Each added technician | Add-on to 97159, up to 5 technicians in total |
97155 (direct treatment) | 97173 (new) | QHP | Treatment with analysis, one patient, face to face |
97155 | 97155 | QHP | Directing a technician, with analysis, client present |
97154 | 97154 | Technician | Group treatment, 2 or more patients |
97156 | 97156 | QHP | Family guidance with analysis, client present or not |
97157 | 97157 | QHP | Multiple-family group guidance with analysis, client not present |
97158 | 97158 | QHP | Group treatment with analysis |
The six new ABA CPT codes explained
97148 and +97149: Harmful-behavior assessment
97148 replaces 0362T. It covers a supporting assessment of harmful behavior, such as self-injury, aggression, elopement or pica, by two technicians in an environment set up for safety. The QHP must be on site and immediately available, which telehealth may satisfy when medically necessary, clinically appropriate and permitted by applicable payer policies, laws and regulations. Add-on +97149 covers each additional technician, up to five in total. Every added technician needs documented medical necessity under a QHP protocol.
97159 and +97160: Harmful-behavior treatment
97159 replaces 0373T and follows the same treatment structure. Add-on +97160 covers each additional technician. Count the two-technician base session once: 60 minutes is four units of 97159, not eight. For +97160, sum the qualifying time of additional technicians before converting it to units. The same distinction applies to 97148 and +97149.
97173: QHP treatment with analysis
97173 covers a QHP delivering one-to-one treatment face-to-face, with analysis. Before 2027, this work was billed under 97155. For example, a BCBA works alone with a client, changes the prompting plan mid-session based on the client’s responses, and documents why. That session is 97173. It can’t be reported concurrently with 97155.
97180: Non-face-to-face QHP work
97180 lets a QHP report clinical work done away from the client, such as data review, protocol decisions, discharge planning and training technicians on a client’s protocols. Its weekly reporting rules are covered below.
What changed for 97155 and the existing codes?
Through 2026, 97155 covered two services: a BCBA directing an RBT, and a BCBA treating the client directly with protocol modification. From January 1, it covers only the first, reported alongside a technician code (97153, 97154, 97148, 97149, 97159 or 97160) while the client is present.
The new word in these descriptors is “analysis,” which the Coalition defines as the QHP’s cognitive work during face-to-face service. It may or may not lead to a protocol change, but it has to be documented either way. Technicians can’t perform it.
The code follows the service delivered, not the credential of the person delivering it:
What’s happening in the session | Code to report |
RBT delivers treatment by protocol | 97153 |
BCBA directs the RBT, with analysis, client present | 97155 with the RBT’s code |
BCBA treats the client one-to-one, with analysis | 97173 |
BCBA covers a cancelled RBT and runs the protocol without analysis | 97153 |
A few other revisions affect day-to-day billing:
- 97151 continues to include qualifying face-to-face and non-face-to-face assessment time; the non-face-to-face component is not new.
- Group codes keep a two-patient minimum, but the CPT eight-patient cap is gone. Clinical appropriateness and payer-specific limits still apply. 97154 and 97158 are reported for each patient attending.
- 97157 is reported for each patient represented by a caregiver or caregiver set, not once for the entire group or separately for every attending adult. If only one family’s caregivers participate, use 97156 when its requirements are met; do not multiply reporting for siblings represented by the same caregiver set.
How to bill 97180 without inviting denials?
97180 is a new CPT code, starting January 1, 2027, that lets a BCBA (or other QHP) bill for clinical work done without the client present. 97180 creates a dedicated code for specified non-face-to-face QHP services; 97151 already includes qualifying indirect assessment work.
97180 is reported per client for a 7-day period, such as Sunday through Saturday. Add up the qualifying time, record each date separately, and report it on one claim line. Cost-share can apply even in a week with no face-to-face services, so tell families early. 97180 can’t be billed on the same day as 97151 for the same client.
Counts toward 97180 | Doesn’t count toward 97180 |
Clinically reviewing and analyzing a client’s progress data and notes | Writing session notes |
Deciding to change a client’s goals or program | Preparing materials |
Deciding whether a client needs more assessment | General team training |
Planning a client’s discharge or move to another service | Calls and emails to coordinate care |
Teaching an RBT how to run a specific client’s program | Administrative quality checks, audits and routine discharge paperwork |
Count only activities specified in the 97180 descriptor; a patient-specific clinical decision alone does not make every activity reportable. Routine or admin work doesn’t count.
Have BCBAs log 97180 time on the day they do the work. Piecing together a week from memory on Friday is hard to back up if a payer audits the claim.
Unit, Telehealth and Pricing Rules for 2027
- Units: ABA codes are billed in 15-minute blocks called units. 8 to 22 minutes is 1 unit, 23 to 37 minutes is 2 units, and less than 8 minutes is not reportable after applying the relevant code’s aggregation rules. For 97180, apply the unit calculation to qualifying time aggregated over the reporting period.
- Time with the client: Most codes only pay for time spent with the client or caregiver. 97151 and 97180 are the exceptions, because they also cover some work done without the client. A BCBA being in the room isn’t billable unless they’re delivering the service.
- Telehealth: Medicare has proposed keeping the existing ABA codes (97151 to 97158) available by telehealth in 2027. It hasn’t decided on the six new codes yet, and a final decision is expected in November 2026. Each state and insurer still sets its own telehealth rules.
- Pricing: Medicare doesn’t set one national price for ABA codes, and it plans to keep it that way in 2027. Each insurer and Medicaid plan sets its own rate, so confirm the applicable fee schedule or contracted rate for each new code and whether a contract amendment is needed. Medicaid rates are not necessarily individually negotiable. The Coalition suggests basing those rates on what each service actually costs your practice.
What happens to authorizations that cross January 1?
Each payer decides whether authorizations that include 0362T, 0373T or 97155 convert automatically or need a new request. Until a payer answers in writing, treat every active authorization that runs past December 31 as at risk.
Start with an inventory of those authorizations, with payer, end date and units remaining. Include 97155, since some of those hours will move to 97173. For new requests, the Coalition points to CASP’s average of 1 to 2 hours of combined QHP activity per 10 hours of technician treatment. This is not an allocation for each QHP code; each client’s medical necessity still drives the request.
The 2027 ABA practice readiness checklist
As of October 26, 2026, approximately nine and a half weeks remain. Assign an owner to each workstream and begin now; payer and system readiness may take longer. The suggested schedule below assumes you start the week of October 26.
Weeks 1 to 3 (Oct 26 to Nov 15): Payers and contracts
- Name one transition owner and an owner for each workstream
- List every payer you bill, including Medicaid managed care plans
- Send each payer a written request using the Coalition’s template letter
- Calculate your cost per service for each new code before discussing rates
Weeks 3 to 5 (Nov 9 to Nov 29): Authorizations
- Inventory active authorizations that include 0362T, 0373T or 97155
- Record each payer’s answer on conversion
- Plan renewals for authorizations that run past December 31
Weeks 4 to 7 (Nov 16 to Dec 13): Systems and claims
- Add the six new codes to your EHR and billing system, effective January 1, 2027
- End-date 0362T and 0373T for services on or after January 1
- Load payer-specific rates as each payer confirms them
- Run test claims through your clearinghouse
Weeks 6 to 8 (Nov 30 to Dec 20): Documentation and training
- Update note templates to capture analysis for 97155, 97173 and 97156 through 97158
- Add a dated 97180 time log for each client
- Train BCBAs on choosing between 97153, 97155 and 97173
- Train billing staff on unit math and add-on codes
Weeks 10 to 14 (Dec 28 to Jan 31): Go-live and monitoring
- Keep 2026 and 2027 dates of service on separate claims
- Review the first two weeks of 2027 claims before submitting them
- Track denials by code and payer, and update billing rules as payer bulletins arrive
Questions to ask every payer before January 1
“Don’t assume payers will contact you,” the ABA Coding Coalition advises. Its guidance for providers suggests asking each payer these questions in writing:
- When will the new codes go live in your claims system, and does that date differ from January 1, 2027?
- Does your crosswalk from current codes to new codes differ from the Coalition’s?
- What is the contracted rate for each new code?
- Will existing authorizations convert automatically, or do we need to submit new requests? What is the submission window?
- How will you handle claims that span the transition, including claims for pre-2027 service dates? Deleted codes remain invalid for dates of service on or after January 1, 2027.
- When will you notify providers of these changes?
Ask for answers by a set date and keep them in one tracker your billing and clinical leads share.
How Caretap helps ABA practices through the 2027 transition?
Code changes put the most pressure on the handoffs between authorizations, scheduling, documentation and billing. Caretap is ABA practice management software that connects those workflows around the ABA session, so your team doesn’t have to be the integration layer.
- Authorization management: Keep authorization information connected to scheduling, utilization and delivered care.
- AI-assisted documentation: Caretap turns supported BCBA and RBT conversations into draft notes. The clinician reviews, edits and approves the final documentation.
- Billing readiness: Your team can see which completed work is ready to move forward and what still needs attention.
- Analytics: Can see utilization, documentation status and billing readiness in one place.
Pricing for established practices starts at $199 a month for your first 10 users. Switching practices may receive free standard migration, staff onboarding and implementation planning, depending on agreed scope. Caretap is rated 4.7/5 on G2 and 4.8/5 on Capterra.
