The Misclassification of Behavior Analysts: How National Provider Identifiers (NPIs) Fail to Adequately Capture the Scope of the Field
Federal data over-count behavior analysts by the tens of thousands—verify every NPI before you trust it.
01Research in Context
What this study did
Dubuque et al. (2021) downloaded every U.S. National Provider Identifier file. They looked for people who picked behavior-analyst taxonomy codes. Then they checked each one against the real BACB certificant list.
The goal was simple: see how many non-credentialed providers call themselves behavior analysts in federal data.
What they found
More than 20,000 providers use behavior-analyst NPI codes without holding BACB or state credentials. That means official counts can overstate the workforce by thousands.
Insurance directories, state maps, and crisis-response plans all lean on this inflated data.
How this fits with other research
Deochand et al. (2016) and Deochand et al. (2024) chart real BACB growth from 1999-2019. Their careful head-counts now look even smaller next to the bloated NPI numbers.
Yingling et al. (2023) show kids with autism outnumber RBTs in most counties. Pair that with Dubuque’s finding and the shortage feels worse: many listed “analysts” cannot actually serve those kids.
Liddon et al. (2024) reveal that day-to-day clinic pressures already block trainees from earning unrestricted hours. If rosters list phantom analysts, planners may wrongly think supervision capacity is ample.
Why it matters
Bad data drives bad decisions. When directories list 20,000 extra “BCBAs,” payers set lower rates, states approve fewer licenses, and families wait longer for real care. Before you refer, contract, or expand, cross-check NPI claims against the BACB registry. Clean lists protect clients, funding, and our professional brand.
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02At a glance
03Original abstract
To remain in compliance with the Health Insurance Portability and Accountability Act of 1996, U.S. health care providers are required to register for a National Provider Identifier (NPI). When applying for an NPI, providers must select the Healthcare Provider Taxonomy Code(s) that most closely describes the services they offer. Three distinct taxonomies describe the services offered by behavior analysts. Two of these codes, the Behavior Analyst (103K00000X) and the Assistant Behavior Analyst (106E00000X) taxonomies, specify that the health care provider must hold either a certification from the Behavior Analyst Certification Board or a state-issued credential to practice behavior analysis. The purpose of this study was to investigate the concordance between health care providers who utilize these behavior-analytic NPI taxonomy classifications and health care providers who meet the credential qualifications specified in the code descriptions. Results indicated that there are potentially more than 20,000 U.S. health care providers who do not hold the behavior analyst credentials specified in the taxonomy descriptions linked to their accounts. The implications of providers being mistakenly classified as credentialed behavior analysts and credentialed assistant behavior analysts in federal data and how the field should respond are discussed.
Behavior Analysis in Practice, 2021 · doi:10.1007/s40617-020-00451-w