ABA Archives - Page 6 of 6

Florida ABA Billing 2026: Medicaid Rate Landscape, PE Roll-Up Density, and the Multi-Payer Modifier Fixes Every FL ABA Practice Needs

Florida is one of the highest-density ABA markets in the US and one of the most competitive PE-backed ABA roll-up battlegrounds. If your practice operates in Florida — whether independent, PE-backed, or founder-led — the 2026 Florida ABA billing environment demands precision that most in-house teams don’t have. Florida ABA billing hits three simultaneous pressures […]

Texas Medicaid U-Series Modifiers For ABA Concurrent Billing 2026: The Modifier Precision Playbook Every Texas ABA Org Needs

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If your ABA practice bills Texas Medicaid, the concurrent billing rules for 97153 and 97155 have gotten more complex in 2026 — and getting the modifier stack wrong is now the single most common cause of denied concurrent claims across Texas ABA practices we work with. Texas Medicaid requires U-series modifiers (U1, U2, U3, and […]

Michigan PIHP Redesign 2026: The ABA + Autism Billing Fixes Every MI Practice Needs Before H0031/H2019 Denials Compound

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If your Michigan ABA or autism-services practice bills through a PIHP (Pre-paid Inpatient Health Plan), 2026 is the year the rules got harder. The Michigan PIHP redesign for 2026 is creating denial cliffs on autism ABA H0031 (assessment) and H2019 (behavioral health services) codes that most in-house billing teams are treating as one-off denials when […]

Indiana Just Cut ABA Rates By 10% Through 2027. Here’s the Multi-Year Playbook for Indiana ABA Orgs.

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Indiana Medicaid is stepping down the ABA 97153 unit rate from $17.06 to $15.39 by 2027. That is a 10% cumulative revenue cut per unit, phased in a way that gives Indiana ABA CFOs a real planning window. The practices that survive this rate cycle will use the phased implementation to their advantage. The practices […]

New York Just Cut ABA 97153 Rates by 14%. Here’s What Every NY ABA Org Needs to Do Right Now.

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If your ABA practice bills New York Medicaid, your revenue just dropped 14% and it’s not coming back. New York Medicaid cut the ABA 97153 unit rate from $16.85 to $14.45 between October 2025 and April 2026. For a mid-size NY ABA practice billing 400 units per week per BCBA-supervised technician, that’s: Old revenue per […]

Vermont Just Killed ABA Concurrent Billing. Michigan, Virginia, and Texas Are Next. Here’s How to Protect Your Revenue.

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If your ABA practice bills concurrent 97153 (behavior technician time under BCBA direction) and 97155 (BCBA protocol modification) simultaneously, 2026 is the year the rules got harder — and different in every state. The biggest news: Vermont Medicaid, effective January 2026, discontinued reimbursement for concurrent billing of 97153 and 97155, restricted telehealth ABA delivery, and […]

ABA Billing 97153 & 97155 Concurrent Denials: Fix Them Now

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Stop losing revenue on 97153 and 97155 concurrent-service denials. Learn the exact modifier, POS, and documentation fixes ABA practices need in 2026.

Outsource ABA Billing Services: When It Pays Off (And When It Doesn’t)

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The honest answer: Outsourcing your ABA billing makes financial sense when your collected revenue per BCBA hour is being suppressed by 4% or more in fixable categories you don’t have time to work. Below that threshold, in-house billing usually wins. Above it, you’re paying yourself to do work an outsourced team can do faster and […]

The 5 Denial Patterns Behavioral Health, ABA, and SUD Practices Lose the Most Revenue To

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We audit a lot of behavioral health, ABA, mental health, and substance use disorder practices. The pattern is almost always the same: 8 to 12 percent of net revenue is sitting in denials that nobody had time to rework. It’s not because the billing team is bad. It’s because there aren’t enough hours in the […]

ABA Supervision-Ratio Audit Checklist: How BCBAs Prevent Retroactive Denials

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15-point ABA supervision audit checklist for BCBAs. Stop retroactive clawbacks on 97155, 97153, 97156, and 97158 across Anthem, Aetna, Magellan, Medicaid.

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Category: ABA

Florida ABA Billing 2026: Medicaid Rate Landscape, PE Roll-Up Density, and the Multi-Payer Modifier Fixes Every FL ABA Practice Needs

Texas Medicaid U-Series Modifiers For ABA Concurrent Billing 2026: The Modifier Precision Playbook Every Texas ABA Org Needs

Michigan PIHP Redesign 2026: The ABA + Autism Billing Fixes Every MI Practice Needs Before H0031/H2019 Denials Compound

Indiana Just Cut ABA Rates By 10% Through 2027. Here’s the Multi-Year Playbook for Indiana ABA Orgs.

New York Just Cut ABA 97153 Rates by 14%. Here’s What Every NY ABA Org Needs to Do Right Now.

Vermont Just Killed ABA Concurrent Billing. Michigan, Virginia, and Texas Are Next. Here’s How to Protect Your Revenue.

ABA Billing 97153 & 97155 Concurrent Denials: Fix Them Now

Outsource ABA Billing Services: When It Pays Off (And When It Doesn’t)

The 5 Denial Patterns Behavioral Health, ABA, and SUD Practices Lose the Most Revenue To

ABA Supervision-Ratio Audit Checklist: How BCBAs Prevent Retroactive Denials