The AMA’s CPT 2027 code set, released September 9, introduces six new Category I adaptive behavior services codes, revises all eight existing codes in the 97151-97158 family, and deletes temporary Category III codes 0362T and 0373T. The restructuring takes effect January 1, 2027.
The adaptive behavior code family expands from the previous eight Category I plus two Category III codes to 14 Category I codes. The CPT Editorial Panel originally approved the restructuring in September 2025.
Additions made
Six new codes cover services that previously lacked a permanent CPT pathway or sat under temporary classification.
| New CPT code | Service |
| 97148 | Harmful-behavior assessment with two technicians in a customized environment (15-min units) |
| +97149 | Each additional technician for the 97148 assessment |
| 97159 | Harmful-behavior treatment with two technicians in a customized environment (15-min units) |
| +97160 | Each additional technician for the 97159 treatment |
| 97173 | Adaptive behavior treatment with analysis, delivered face-to-face by a physician/QHP (15-min units) |
| 97180 | Specified non-face-to-face adaptive behavior services by a physician/QHP (15-min units) |
Source: ABA Coding Coalition; CMS CY 2027 PFS proposed rule
The harmful-behavior codes (97148/97149 and 97159/97160) replace the function previously served by temporary 0362T and 0373T.
Those services move from Category III temporary coding into permanent Category I coding — reflecting greater maturity and standardization, though Category I status does not itself guarantee payer coverage.
The 97155/97173 split
This separation is likely the most operationally disruptive change for billing teams.
Beginning in 2027, 97155 narrows to describe direction of a technician plus analysis by the physician/QHP while face-to-face with the patient. Direct treatment delivered by the QHP — treatment with analysis — moves into the new 97173.
The practical effect is a three-way separation that previously lived more closely together.
- 97153 — technician delivers protocol-based treatment
- 97155 — QHP analyzes treatment while directing a technician
- 97173 — QHP directly treats the patient while performing analysis
APBA is specifically warning providers that the changes affect service delivery, code selection, documentation, and organizational workflows.
Session documentation needs to make the correct treatment scenario clear, because the code selected depends on who performed the service and what type of analysis occurred — not simply that a session happened.
97180 may be the most important new code (but why?)
Under the current structure, general treatment planning or technician supervision performed without the patient present does not have a stand-alone adaptive behavior CPT code (apart from non-face-to-face assessment work incorporated into 97151).
97180 changes that.
It creates a reporting pathway for specified non-face-to-face clinical work personally performed by a physician or other qualified healthcare professional. The eligible activities are specific.
- Developing discharge or transition plans
- Developing or revising assessment protocols
- Modifying treatment targets, goals, or protocols
- Determining whether additional assessment is needed
- Reviewing and analyzing patient treatment data and session notes
- Training technicians on revised treatment or assessment protocols
- Determining whether treatment targets, goals, or protocols need modification
CPT 97180 — SCOPE
Specified non-face-to-face clinical work — not everything a BCBA does
Covered by 97180
Patient-specific treatment data analysis
Protocol modification and goal adjustment
Assessment protocol development or revision
Discharge/transition planning
Technician training on revised protocols
Not covered by 97180
General employee supervision
Administrative meetings
Staff scheduling
Generic (non-patient-specific) training
Non-clinical business activity
Source: ABA Coding Coalition; AMA CPT 2027 descriptors
The CPT descriptors use the phrase “physician or other qualified health care professional” — not simply “BCBA.”
Whether a particular professional qualifies as an eligible QHP for billing depends on state licensure, payer policy, credentialing, and the applicable benefit structure.
CPT approval ≠ equal payer payment
AMA makes clear that having a service represented by a CPT code does not itself establish insurance coverage or reimbursement.
A new 2027 code does not automatically tell a provider whether a commercial insurer or Medicaid will cover it, what rate will apply, what authorization is required, or which provider types may submit it.
CMS addressed the revised family in the proposed CY 2027 Medicare Physician Fee Schedule (published July 14) and proposed contractor/carrier pricing rather than standardized national work RVUs.
As of September 26, the final rule has not been issued. CMS also did not specifically address telehealth coverage for the six new codes in the proposed rule.
What practices should do before January 1?
The operational preparation is broader than adding six rows to a billing system.
Update EHR Code Libraries
Add the six new 2027 codes and update the revised 97151–97158 descriptors before January 1 services.
Retire the Deleted T Codes
Stop using 0362T and 0373T for dates of service beginning January 1, 2027.
Revise Documentation Templates
Capture the 97153 / 97155 / 97173 distinctions, including who performed the service and what type of analysis occurred.
Confirm Payer Requirements
Contact each payer about coverage, reimbursement, authorization units, and provider-credential requirements for the new codes.
Reconcile Existing Authorizations
Review authorizations referencing 0362T, 0373T, or the pre-2027 97155 and map them to codes valid for January 1 services.
Watch the CMS Final Rule
Check the final CMS rule for Medicare payment and telehealth treatment when released, currently expected in early November.
The goal is simple…make sure your systems, documentation, authorizations, and payer rules are all aligned before the first 2027 claim goes out.
