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North Carolina Medicaid and ABA therapy

Yes. NC Medicaid covers ABA and other proven autism treatments under its Research-Based Behavioral Health Treatment (RB-BHT) benefit, Clinical Coverage Policy 8F.

  • 9Medicaid plans with a directory
  • $20.81per 15 minutes, code 97153 (2026)
  • 165ABA providers in our North Carolina cities

At 40 hours a week, North Carolina Medicaid's technician rate comes to $3,329.60 of billed ABA, the highest of the 6 states on this list. Source: NC Department of Health and Human Services, Division of Health Benefits fee schedule (2026).

Filling in a North Carolina Medicaid application form at a kitchen table

How to get ABA therapy through North Carolina Medicaid

  1. Get the diagnosis. The child needs an autism diagnosis made with a proven testing tool. A licensed psychologist, licensed psychological associate, or doctor can make the full diagnosis. For children under 3, a provisional diagnosis is accepted, but a full diagnosis is needed within six months. Source: NC Department of Health and Human Services, NC Medicaid.
  2. Find a provider that takes your plan. Use the list for your city, then check the plan's own directory below.
  3. The provider asks for approval. The provider must get prior approval before starting. Plans of 16 hours a week or less are approved for up to 180 days. Plans over 16 hours a week are approved for up to 90 days and must be renewed every three months. Source: NC Department of Health and Human Services, NC Medicaid [2].
  4. Hours are set by need. There is no fixed weekly cap. Hours are based on medical necessity shown in the treatment plan, and plans over 16 hours a week get shorter approvals. Source: NC Department of Health and Human Services, NC Medicaid.

The rules in North Carolina

Programme
NC Medicaid (NC Medicaid Direct and NC Medicaid Managed Care health plans) Source: NC Department of Health and Human Services, NC Medicaid [2].
Age limit
Children and young adults under 21, under the federal EPSDT rule that covers medically necessary care for this age group. Source: NC Department of Health and Human Services, NC Medicaid.
Who can provide it?
A licensed provider such as a licensed behavior analyst, psychologist, or doctor writes and oversees the treatment plan. Behavior technicians must be certified as a Registered Behavior Technician (RBT) or ABA Technician within 120 days of hire. Source: NC Department of Health and Human Services, NC Medicaid.
What Medicaid pays
$20.81 per 15 minutes for technician-delivered ABA (97153), 2026 schedule. $32.22 per 15 minutes when the analyst adjusts the plan (97155). Source: NC Department of Health and Human Services, Division of Health Benefits.
Official page
Clinical Coverage Policy No. 8F: Research-Based Behavioral Health Treatment (RB-BHT) for Autism Spectrum Disorder (ASD) Source: NC Department of Health and Human Services, NC Medicaid.

Medicaid plans in North Carolina and their provider directories

Most children on North Carolina Medicaid are in a managed care plan. ABA providers must be in your plan's network, so search the plan's own directory for "applied behavior analysis".

The state's own Medicaid provider search Source: NC Medicaid Managed Care (NCDHHS).

ABA therapy that accepts Medicaid in North Carolina, by city

The public register doesn't record which plans a provider takes, so every list below shows all registered ABA providers. Ask each one the same thing: "Are you in network with my Medicaid plan?"