AHCA shows the task force its ABA rates and how other states limit hours
At the October 29 meeting, AHCA reviewed Florida Medicaid's current rules: up to 40 hours of ABA per week with prior authorization, a behavior plan of up to six months, and fee-for-service rates per 15-minute unit ($12.26 for 97153 and $19.05 for 97151). It pointed to North Carolina (over 16 hours: reauthorization every three months), Virginia (over 20 hours: extra documentation) and California (2026 proposal: more review above 25 hours), and discussed electronic visit verification (EVV) as a possible tool to match visits against claims. These were presentations, not decisions: meeting 6 is scheduled for November 17.
According to AHCA, the new and revised CPT codes that take effect January 1, 2027 don't change Medicaid coverage or rates on their own: until there's a notice, follow the current rules and document progress and parent participation, which is what's required for reauthorization.
“National CPT code changes do not independently establish Medicaid coverage, reimbursement rates, eligible practitioners, or authorization requirements.”
Sources
- AHCA · Meeting 5 materials (PDF) Oct 29, 2026 ↗
- AHCA · Meeting 5 agenda (PDF) Oct 29, 2026 ↗
- AHCA · Approved Meeting 4 minutes (PDF) Oct 29, 2026 ↗
- AHCA · ABA Task Force ↗
High certainty · Verified on Nov 3, 2026