The Six New Autism CPT Codes Coming in 2027 — A Data & Infrastructure Shift, Not a Billing Shift
Note: The AMA CPT Editorial Panel approved six new autism-related CPT codes in September 2025, effective January 1, 2027. Final code descriptors remain confidential until publication in the 2027 CPT® Professional Codebook. The six categories outlined below are interpretive themes — a technology and operations lens on what these codes are likely to represent — not official AMA language.
These interpretive themes below are informed by coalition announcements and conversations with industry leaders about likely operational impacts.
Starting January 2027, the AMA will introduce six new CPT codes related to autism.
Most people will focus on the clinical definitions, but the real impact is most likely going to be operational and architectural.
These codes may force a shift in how data is captured, how workflows are structured, how systems talk to each other, and how payors expect that data to flow.
Before diving into impact, here’s what the six codes most likely represent.
The Code Themes (Tech/Ops Interpretation)
1. Foundational Autism Evaluation - A baseline evaluation mapped to a standardized, repeatable workflow.
2. Complex / Multidisciplinary Evaluation - A higher-complexity evaluation requiring branching steps, additional participants, or expanded data capture.
3. Technology-Assisted / Digital Phenotyping Assessment - An evaluation that includes video, sensors, scoring engines, or AI-supported tools.
4. Interdisciplinary Care Planning & Coordination - A structured collaboration event across roles, settings, or systems — treated as a billable workflow.
5. Caregiver / Family Support Training (Separate Track) - A distinct workflow for caregiver-facing sessions with its own rules, schedule types, and documentation model.
6. Plan-of-Care Review / Re-Evaluation A recurring workflow for reviewing progress, updating goals, and justifying continued services.
Why the 2027 Codes Matter for Tech, Ops & Data
The biggest shift isn’t the codes themselves —it’s that they redefine what counts as a discrete, reportable operational event.
Evaluations, coordination, caregiver training, and re-evaluation are no longer PDF-based activities.
They become structured workflows with data attached.
To understand the implications, two concepts matter most:
evaluation workflows and evaluation templates.
What an Evaluation Workflow Is (Tech/Ops Definition)
An evaluation workflow is the system-defined sequence of steps that turns an assessment into structured, traceable data:
- intake and history
- assigned evaluators
- required evaluation components
- digital inputs
- structured summary
- routing to authorization
Most organizations still treat evaluations as documents.
The 2027 codes will most likely assume they are multi-step workflows with timestamps, roles, and required components.
What an Evaluation Template Is (Tech/Ops Definition)
An evaluation template is the data blueprint defining what fields and components must be captured, including:
- required fields
- required evaluation components
- optional complex or tech-assisted modules
- structured decision fields
- mappings to treatment plans and authorizations
Today, most templates are still PDF-like forms. The new codes push toward structured, queryable data schemas.
Will Today’s ABA Platforms Support These Requirements?
Most ABA practice-management platforms were built around the 2019 code set, when evaluations were still treated as documents.
Without meaningful updates, users will face limitations in 2027:
- Evaluations will remain PDFs, not structured data that differentiates foundational vs. complex vs. tech-assisted.
- Templates will remain static forms, not modular workflows with required and optional components.
- Plans won’t link cleanly back to evaluation data, making re-evals and authorizations harder to justify.
- Care-coordination activities won’t exist as discrete system events, limiting auditability and billability.
- Digital inputs won’t have ingestion points, making tech-assisted assessments hard to operationalize.
- Scheduling and billing systems won’t distinguish new service types, leading to denials and manual workarounds.
These gaps reflect structural limitations in how most platforms store data and route workflows.
Supporting the 2027 codes will most likely require a shift to event- and data-centric architectures.
What These Codes Mean for DRBI and Other Non-ABA Models
None of the new 2027 CPT codes will likely create a billable pathway for delivering DRBI-style treatment directly.
But they may open meaningful adjacent pathways that developmental, relationship-based, and hybrid models can legitimately plug into:
1. Expanded Caregiver/Family Training
The new caregiver code is most likely not ABA-specific, aligning naturally with parent-mediated developmental approaches.
2. Interdisciplinary Care Coordination
DRBI programs often involve psychologists, SLPs, OTs, and developmental pediatricians — this code finally makes that collaboration billable.
3. Digital/Observational Assessment
The tech-assisted assessment code will probably support structured relational or developmental assessments that rely on video or observational coding.
4. Structured Plan-of-Care Reviews
The new re-evaluation code should allow developmental progress to be reviewed and justified in a more structured, payor-aligned way.
Bottom line:
These codes probably won't authorize DRBI treatment, but they may strengthen the infrastructure around developmental models — especially in evaluation, coordination, parent coaching, and progress tracking.
Providers: Your Advantage Will Come From Better Workflows, Not Just More Clinicians
Evaluation workflows must become structured and reproducible.
Payors will expect clear, consistent data.
Your Practice Management/EHR platform becomes the bottleneck or the enabler.
Systems must support:
- multiple evaluation types
- data lineage
- digital input ingestion
- structured coordination events
- multi-service scheduling
Renewals become a data problem.
The re-evaluation code requires clear progression from eval → plan → service → review.
Platforms: You’re Being Forced to Rebuild the Backend
This is the most significant shift since the 2019 code transition.
Evaluation → Plan → Notes → Billing must become a single data chain.
Today, these are often silos.
Backends must shift from static forms to event-driven workflows.
Evaluations, coordination, parent training, and re-evals become system events with metadata.
Digital assessment integration becomes table stakes.
Platforms must support scoring engines, video ingestion, and metadata capture.
Scheduling/authorization logic must recognize new service types.
Caregiver training ≠ evaluation ≠ tech-assisted assessment ≠ re-eval.
Investors: A New Layer of Defensibility Is Emerging
Tech-enabled diagnostics gain real reimbursement pathways.
New Market for video analysis, sensors, and hybrid evaluations.
Platforms with structured data models will separate from laggards.
Document repositories won’t survive enterprise RFPs.
Providers with scalable evaluation infrastructure gain valuation advantages.
These codes reward clean workflows and interdisciplinary capacity.
The Readiness Window
Providers
- audit workflows
- demand structured evaluation support
- clean up documentation models
- prepare for multi-service scheduling
Platforms
- rebuild evaluation modules
- add branching logic
- support ingestion of digital assessments
- create care-coordination objects
- unify eval → plan → notes → billing
Investors
- evaluate data architecture readiness
- back diagnostic innovators
- prioritize providers with scalable evaluation infrastructure
Bottom Line
These new six CPT codes likely don’t change autism care delivery.
They change how autism care must be modeled in software.
This could drive a schema update for the entire ecosystem —
one that will reshape workflows, data structures, platform architecture, and investment priorities.
Clinically, this may look like “more codes.”
Operationally, it’s the start of a new infrastructure era in autism tech.
References and Sourcing Notes
- ABAI Billing Codes Commission: Changes are coming to our CPT Billings Codes in 2027
- ABA Coding Coalition: ABA CPT Codes Update
- CASP: ABA Coding Coalition Announces AMA Approval of Code Change Application
Interpretive Framework (the six categories):
The six categories described in this post are not official AMA descriptors.
They are operationally inferred themes based on public industry conversations and the structural needs implied by the new code set — not on any published CPT language.
No AMA CPT descriptor content was accessed, referenced, reproduced, or inferred in this article.
