Behavior technicians took 22.5% of new individual NPIs in 2025, up from 4.5% in 2017
NPPES data: 114,687 behavior technicians received an NPI in 2025, more than nurse practitioners, physician assistants and behavior analysts combined.
Key findings
- In 2025, 114,687 behavior technicians received a National Provider Identifier: 22.5% of the 509,511 individual NPIs issued that year. In 2017, the first full year of the code (NUCC added 106S00000X in July 2016), the figure was 11,745, or 4.5%.
- Behavior technicians received more new NPIs in 2025 than nurse practitioners (28,869), physician assistants (10,423) and behavior analysts (6,185) combined.
- 580,469 records in the registry now carry the behavior technician taxonomy, more than the 518,916 nurse practitioner records.
- Michigan stands out: 22.1% of its provider records are behavior technicians, with 19.9 technicians for every registered behavior analyst, against 5.3 nationally.
New registrations grew from 11,745 in 2017 to 114,687 in 2025
Source: CMS NPPES, primary taxonomy 106S00000X by enumeration year, file of Aug 9, 2026 (cms.gov).
Why the registry holds more than twice as many as the BACB certifies
The Behavior Analyst Certification Board began certifying Registered Behavior Technicians in 2014, and a technician who is billed for sessions needs an NPI. An NPI is not deactivated when certification lapses or a technician leaves the field, so the registry keeps counting them: 580,469 records against 260,174 current certificants on Jul 1, 2026.
Source: CMS NPPES, file of Aug 9, 2026; BACB certificant data, Jul 1, 2026 (bacb.com).
Most per resident: the six highest states
Source: CMS NPPES, code 106S00000X by practice state; 2023 Census estimates. Records per 100,000 residents.
What this does and does not show
- Behavior technicians deliver applied behavior analysis under a supervising behavior analyst.
- A record is a registration, not proof that the person works today.
- Counts use the primary taxonomy as it reads today; a record that changed code counts under its current one.
Research question
Every clinician who bills a US health plan needs a National Provider Identifier, so the dates on which NPIs are issued are a near real-time record of who is entering the paid healthcare workforce. We asked which provider type has grown fastest in that record over the last decade, and where the growth is concentrated.
Methodology
We used PlainDoctor's copy of the CMS NPPES registry of individual providers (table providers, 7,327,918 records, one row per NPI with its primary taxonomy code and enumeration date in MM/DD/YYYY form). Behavior technicians are taxonomy 106S00000X, behavior analysts 103K%, nurse practitioners 363L% and physician assistants 363A% in the NUCC code set. The yearly series comes from this query:
SELECT substr(enumeration_date,7,4) AS yr, count(*) AS total,
sum(specialty_code='106S00000X') AS behavior_tech,
sum(specialty_code LIKE '103K%') AS behavior_analyst,
sum(specialty_code LIKE '363L%') AS nurse_practitioner,
sum(specialty_code LIKE '363A%') AS physician_assistant
FROM providers
WHERE substr(enumeration_date,7,4) BETWEEN '2015' AND '2025'
GROUP BY 1 ORDER BY 1; State figures group the same table by state across all enumeration years (SELECT state, count(*), sum(specialty_code='106S00000X'), sum(specialty_code LIKE '103K%') FROM providers GROUP BY state). Registry totals by type use the same filters without the year condition.
Findings
From 11,745 to 114,687 new NPIs a year
Behavior technicians carry out applied behavior analysis (ABA) sessions, most often for children with autism, under the supervision of a board-certified behavior analyst. NUCC Health Care Provider Taxonomy Code Set NUCC added the behavior technician code, 106S00000X, in July 2016, so earlier years count only NPIs whose holders switched to the code later (452 of those issued in 2015). In 2017, the code's first full year, 11,745 NPIs were issued to people who list it today; the number crossed 50,000 in 2021 and reached 114,687 in 2025. CMS NPPES NPI Registry Over the same period the total number of individual NPIs issued each year rose from 260,297 to 509,511, and behavior technicians account for 41% of that increase.
Individual NPIs issued per year, by primary taxonomy (current NPPES records)
| Year | All new NPIs | Behavior technicians | Share | Behavior analysts | Nurse practitioners |
|---|---|---|---|---|---|
| 2015 | 224,414 | 452 | 0.2% | 5,462 | 21,973 |
| 2016 | 245,546 | 2,694 | 1.1% | 7,505 | 24,430 |
| 2017 | 260,297 | 11,745 | 4.5% | 7,358 | 25,774 |
| 2018 | 324,705 | 27,176 | 8.4% | 11,760 | 28,384 |
| 2019 | 328,415 | 35,151 | 10.7% | 10,231 | 31,438 |
| 2020 | 347,667 | 34,113 | 9.8% | 8,375 | 30,881 |
| 2021 | 376,077 | 54,152 | 14.4% | 9,354 | 33,409 |
| 2022 | 382,262 | 61,455 | 16.1% | 7,071 | 31,707 |
| 2023 | 414,781 | 76,394 | 18.4% | 6,419 | 32,623 |
| 2024 | 440,353 | 91,912 | 20.9% | 5,994 | 30,169 |
| 2025 | 509,511 | 114,687 | 22.5% | 6,185 | 28,869 |
More technicians than nurse practitioners
Across all years, 580,469 records in the registry list behavior technician as their primary taxonomy, or 7.9% of the 7,327,918 individual records. That is more than the 518,916 nurse practitioner records. Only 1,567 of those records were issued in 2015 or earlier, before the code existed. In 2025 alone technicians received more NPIs than nurse practitioners, physician assistants and behavior analysts put together (45,477). The supervising workforce has not grown at the same pace: behavior analysts received 6,185 NPIs in 2025, fewer than in 2018, so the registry added 18.5 technicians for every new analyst that year. Nationally there are 5.3 technician records per analyst record.
Concentrated in a few states, led by California and Michigan
California has the most technicians, 171,666, which is 17.6% of its provider records. Michigan has fewer in absolute terms, 63,468, but they make up 22.1% of all its records, the highest share among large states, and Michigan's registry lists only 3,195 behavior analysts, a ratio of 19.9 technicians per analyst. Texas, with 433,013 provider records, has 25,158 technicians (5.8%), a third of Florida's count.
States with the most behavior technician NPIs (all enumeration years)
| State | Behavior technicians | Share of state records | Behavior analysts | Technicians per analyst |
|---|---|---|---|---|
| California | 171,666 | 17.6% | 20,348 | 8.4 |
| Florida | 75,633 | 16.1% | 13,565 | 5.6 |
| Michigan | 63,468 | 22.1% | 3,195 | 19.9 |
| Texas | 25,158 | 5.8% | 5,837 | 4.3 |
| Maryland | 25,139 | 15.7% | 1,550 | 16.2 |
| Indiana | 17,050 | 14.1% | 2,150 | 7.9 |
| Minnesota | 16,115 | 12.0% | 1,393 | 11.6 |
| North Carolina | 13,243 | 6.6% | 2,342 | 5.7 |
What this analysis cannot tell us
An NPI shows that someone registered to be identified on claims, not that they are still working or how many hours they bill. The counts use each record's current primary taxonomy, so a person who later changed taxonomy is counted under the new one, and deactivated NPIs are not in the file. For the same reason the physician counts in recent years are not comparable: most new physicians register as residents under the student taxonomy and switch later, which is why this study does not compare technicians with physicians by year. State is the practice-location state on the record. The data says nothing about the quality of ABA services, why states differ, or how much any payer spends on them.
Sources
- CMS National Plan and Provider Enumeration System (NPPES) NPI Registry: https://download.cms.gov/nppes/NPI_Files.html
- NUCC Health Care Provider Taxonomy Code Set: https://taxonomy.nucc.org/