03/20/2025
If you know me then you know that children with Autism were my first love. Some of those children belong to you. I want you to know that the Governor has proposed drastic cuts that will affect tens of thousands of children with an Autism Spectrum Disorder Diagnosis and their families and I am going to fight tooth and nail against that and I hope you will help me. Please click the voter voice link at the end and share your story.
Governor Holchul's proposed budget includes a 28.6 million dollar reduction in Medicaid-funded applied behavior analysis (ABA) over the next two years. The reduction focuses on CPT code 97153, the code for direct one-on-one ABA services by a technician (under the supervision of a QHP-LBA). This service accounts for 80-90% of billed charges. The proposed rate of $9.63 per 15-minute unit will be the lowest publicly available rate in the country. Many Medicaid providers may be required to exit the network and stop rendering services to Medicaid beneficiaries to remain in business. This means all ABA services through New York Medicaid are at risk. It also means that many provider organizations may be placed in an unfortunate position where they must evaluate if they can continue doing business in New York. There could be far-reaching effects, not just for the estimated 30,000 Medicaid beneficiaries eligible for this benefit, but for children with commercial insurance coverage, too.
It has become clear that the New York Division of the Budget and the legislature do not understand the tiered service delivery model or the rigorous training, oversight, direction, and supervision behavior technicians, including Registered Behavior Technicians (RBTs), are required to go through to obtain and maintain their credentials.
I need your help to ensure equitable access to medically necessary ABA across New York.
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Governor Holchul's proposed budget includes a 28.6 million dollar reduction in Medicaid-funded applied behavior analysis (ABA) over the next two years. The reduction focuses on CPT code 97153, the code for direct one-on-one ABA services by a...
