The 2027 ABA CPT Code Changes: What Families Should Check Before January

The 2027 ABA CPT code changes take effect on January 1, 2027. The American Medical Association’s 2027 code book adds six new codes for ABA, retires the two temporary codes for severe behavior, and splits the BCBA’s main treatment code in two. If your child is in ABA now, or will start around the new year, the change can show up on your authorization letter and your explanation of benefits (EOB).

This is a coding change, not a coverage change. Your child’s right to medically necessary ABA does not change on January 1, and neither do your deductible or coinsurance. But every insurer has to load the new codes, set rates, and decide what happens to authorizations that cross the date, and families are the ones who notice when that goes badly. Here is what is changing and what to ask.

What changes on January 1, 2027

The ABA Coding Coalition, the group of professional organizations that applied for the revision, publishes the code list. The AMA released the 2027 code set on September 9, 2026. The ABA family grows from 10 codes to 14 permanent ones.

What it covers	Code in 2026	Code from January 1, 2027
BCBA assessment	97151	97151 (wording revised)
Technician supporting assessment	97152	97152
Supporting assessment of harmful behavior, two or more technicians	0362T	97148, plus 97149 for each additional technician
Technician therapy, one child	97153	97153
Technician group therapy	97154	97154
BCBA directing a technician during a session	97155	97155 (narrowed to this)
BCBA treating the child directly	97155	97173 (new)
Treatment of harmful behavior, two or more technicians	0373T	97159, plus 97160 for each additional technician
Caregiver coaching, one family	97156	97156
Caregiver coaching, multiple families	97157	97157
BCBA-led group therapy	97158	97158
BCBA work without the child present	No separate code	97180 (new)

For most families, three things matter: the change to 97155, the new 97180, and what happens to an authorization that runs past December 31.

The 97155 split

Today, 97155 is the code a BCBA bills when they adjust your child’s program in a session. That covers two very different visits. In one, the BCBA watches the technician work with your child, coaches the technician, and changes the plan. In the other, the BCBA works with your child directly.

From 2027, those are separate codes. The coalition’s descriptor for 97155 is “direction of technician and analysis,” face-to-face with the child. When the BCBA treats your child without directing a technician, the new code is 97173, “adaptive behavior treatment with analysis.”

Why it matters to you: if your current authorization approves a block of 97155 hours and some of that time is the BCBA working with your child directly, part of those hours belong under a code your authorization does not list yet. Ask whether the provider is requesting 97173 hours for 2027.

97180: BCBA time when your child is not there

Good ABA involves a lot of work families never see. The BCBA graphs session data, decides whether a goal is working, rewrites a protocol, and plans the move to fewer hours or to school. Until now, most of that time had no code of its own outside the assessment code, 97151.

The new 97180 covers “adaptive behavior non-face-to-face services,” personally performed by a BCBA or other qualified professional, according to the coalition’s code list. Billing vendors summarizing the descriptor list data review, changes to targets and protocols, discharge and transition planning, and training technicians on revised protocols.

Two things to know. First, each insurer decides whether it pays 97180 and how much. Second, if it does, your EOB may show BCBA charges on days your child had no session. That is not a red flag by itself. It is a red flag if no one told you the code would be billed, or if the time billed does not match the work you see reflected in updated plans and progress reports. Our post on ABA billing red flags covers how to compare an EOB to what actually happened.

The codes for severe behavior

Codes 0362T and 0373T were temporary Category III codes for assessment and treatment of severe behavior, such as serious self-injury or aggression, that needs a BCBA plus two or more technicians in a specially set-up room. In 2027 they become permanent codes: 97148 and 97149 for assessment, 97159 and 97160 for treatment.

Most children never need these services. If your child does, this is the part of the change to watch most closely. Insurers that set rates for the old codes will have to set new ones, and authorizations listing 0362T or 0373T will need to move to the new numbers.

What to ask your provider before January

On October 8, 2026, the coalition sent ABA providers a letter template for insurers. It lists the questions providers need each insurer to answer: when the new codes go live in the claims system, how each old code maps to its successor, the rate for each new code, whether existing authorizations convert automatically or need new requests, how claims are handled for dates of service around the transition, and whether there is a grace period for the old codes.

Those are the same questions you should ask your provider, in plain terms:

1. Has our insurer said how it is handling the new codes? A provider that has written to its payers will know, or will know who has not answered yet.
2. Does our authorization run past December 31? If yes, ask whether it lists 97155, 0362T, or 0373T, and whether the insurer will convert it or needs a new request.
3. Will you request 97173 or 97180 for my child? Ask what each would cover in your child’s program and how many hours.
4. If the insurer is late, what happens to sessions in January? Ask whether services continue while authorizations are updated, and who is responsible if a claim is denied for a coding mismatch.
5. When will we see the new codes on our statements? Then check your first EOBs in 2027 against the session calendar.

Apple Health, Medicare rules, and the timeline

Washington Apple Health publishes its own ABA billing guide and fee schedule. The current versions are the January 1, 2026 billing guide and a fee schedule effective July 1, 2026, which still use the 2026 codes. As of October 23, 2026, HCA has not posted a 2027 version. Watch for one before January. Until it is published, no one can say whether Apple Health will pay 97173 or 97180, or which codes it will allow by video. Our post on which ABA codes Washington pays by video covers the current telehealth rules, and the Apple Health ABA guide covers the rest of the Medicaid path.

At the federal level, CMS’s proposed 2027 Medicare physician fee schedule, released in July, listed the new ABA codes with placeholder numbers and left them priced by each Medicare contractor, according to APBA’s summary. The final rule usually comes out in November. Medicare rarely pays for children’s ABA, but its code decisions often shape what other payers do.

Commercial insurers set their own schedules. Cigna’s ABA policy is due for review on December 15, 2026. Premera and Regence publish policy updates on their own calendars. Our insurer posts for Premera, Regence, and Cigna will note the 2027 codes as each policy is updated.

What does not change

• 97153 stays. Most hours in most ABA programs are technician therapy, and that code keeps its number.
• 97156 stays. Caregiver coaching keeps its code. Our post on what CPT 97156 should look like still applies.
• 97151 stays. The ABA assessment is still billed under 97151, with revised wording.
• Your coverage rights stay. Washington’s parity law and Apple Health’s EPSDT protection for children do not depend on code numbers. If a claim is denied only because of a coding mismatch during the transition, that is a fixable billing error, not a coverage decision. Our appeal guide covers what to do if it is not fixed.

How Orchid is handling the change

Orchid’s billing team handles authorizations and reauthorizations for families, including the move to the 2027 codes. If your child is an Orchid client and has an authorization that runs past December 31, your intake or billing contact can tell you which codes it lists and what your insurer has said. If you are choosing a provider now and expect to start around the new year, ask us the same five questions above. You can request a call back or read our Washington ABA insurance guide.