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One in five new NPIs in 2025 went to a behavior technician
ProfessionLens, 2026-10-26
CMS issued 518,843 new NPIs to individual people in 2025, up from 447,906 in 2024. The largest single group was behavior technicians, the entry-level staff who deliver ABA therapy to autistic children: 114,625 of them, or 22.1% of every new individual NPI. That is almost four times the 29,112 nurse practitioners who registered in the same year.
We expected the growth to come from nurses and therapists. Most of it came from two places: behavior technicians, and one state.
Behavior technicians
| Year | New individual NPIs | Behavior technicians | Share |
|---|---|---|---|
| 2019 | 332,863 | 35,032 | 10.5% |
| 2020 | 353,322 | 33,979 | 9.6% |
| 2021 | 381,162 | 53,934 | 14.1% |
| 2022 | 387,720 | 61,267 | 15.8% |
| 2023 | 421,871 | 76,177 | 18.1% |
| 2024 | 447,906 | 91,733 | 20.5% |
| 2025 | 518,843 | 114,625 | 22.1% |
Source: ProfessionLens, October 2026.
Behavior technician registrations more than tripled between 2019 and 2025. California had 31,659 of the 2025 registrations, Florida 14,201 and Michigan 11,780. Indiana went from 1,580 in 2024 to 7,931 in 2025. The pace has leveled off: 77,424 registered from January to August 2026, against 76,535 in the same months of 2025.
Nebraska
Nebraska has about 2 million residents. Its practice addresses received 3,841 new individual NPIs in 2024 and 29,999 in 2025, which is 37% of the national increase. In February 2025 alone 6,069 people in Nebraska registered, against 198 in February 2024.
The cause is a state rule. Nebraska Medicaid Provider Bulletin 24-24, dated 26 November 2024, told home and community based service providers that from 1 January 2025 every independent provider and every direct care worker at an agency needs a Type 1 individual NPI.
| Nebraska, new NPIs by taxonomy | 2024 | 2025 |
|---|---|---|
| Technician (mostly personal care attendants) | 649 | 10,161 |
| Adult Companion | 229 | 4,047 |
| Home Health Aide | 23 | 3,399 |
| Chore Provider | 55 | 2,547 |
| Day Training/Habilitation Specialist | 23 | 2,204 |
| Homemaker | 3 | 770 |
Source: ProfessionLens, October 2026.
Monthly registrations in Nebraska fell back to about 1,100 to 1,400 in 2026, nearly four times the 2024 rate.
Fastest growing taxonomies in 2025
Among taxonomies with at least 500 new NPIs in 2024:
| Taxonomy | 2024 | 2025 | Change |
|---|---|---|---|
| Adult Companion | 860 | 4,873 | +466.6% |
| Day Training/Habilitation Specialist | 1,630 | 4,537 | +178.3% |
| Home Health Aide | 4,824 | 12,007 | +148.9% |
| Technician | 12,890 | 22,776 | +76.7% |
| Health & Wellness Coach | 1,259 | 1,888 | +50.0% |
| In Home Supportive Care | 973 | 1,406 | +44.5% |
| Assistant Behavior Analyst | 1,083 | 1,555 | +43.6% |
| Doula | 3,221 | 4,499 | +39.7% |
| Registered Nurse | 19,267 | 24,863 | +29.0% |
| Behavior Technician | 91,733 | 114,625 | +25.0% |
Source: ProfessionLens, October 2026.
The top four are home care jobs, and Nebraska drives each of them. Doulas are a separate trend: 429 registered in 2019 and 4,499 in 2025. Registered nurses are still accelerating, with 25,336 new NPIs from January to August 2026 against 16,093 a year earlier.
How we counted
Source: ProfessionLens, October 2026. CMS NPPES full replacement file, September 2026, and NUCC taxonomy code set 26.1. We counted individual records (entity type 1) by the year on the enumeration date and gave each NPI one taxonomy: the slot flagged as primary, or slot 1 when none is flagged. State is the practice location address.
The taxonomy is the one on file today, not the one picked at registration. Medical residents usually register under the student code and switch to a specialty later, so recent years undercount physicians and overcount students. We left physician specialties out of the growth ranking for that reason. Deactivated NPIs carry no entity type on the file and drop out. The script and the files are in the dataset folder.
Data
- new_individual_npis_by_year.csv
- new_npis_by_classification.csv
- new_npis_by_classification_and_state.csv
- new_npis_by_specialization.csv
- README.md
- METHOD.md
- facts.json
Cite this
ProfessionLens, One in five new NPIs in 2025 went to a behavior technician, 2026-10-26, https://professionlens.com/research/one-in-five-new-npis-in-2025-went-to-a-behavior-technician.