Does Medicaid Cover ABA Therapy in North Carolina?
Yes — North Carolina Medicaid covers Applied Behavior Analysis (ABA) therapy for children and adolescents diagnosed with Autism Spectrum Disorder (ASD). ABA therapy is a highly effective, evidence-based treatment that helps children with autism develop communication, social, and daily living skills.

Coverage is provided through Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, which guarantees medically necessary services for individuals under 21 — including ABA therapy. At Blue Jay ABA, we’re proud to support North Carolina families by providing accessible, Medicaid-covered care.
Key Points About Medicaid’s ABA Therapy Coverage in North Carolina
Medicaid Coverage Through EPSDT
EPSDT is a federal Medicaid mandate that requires states to cover all medically necessary care for Medicaid-enrolled children under the age of 21. If your child qualifies for ABA therapy based on medical necessity,
NC Medicaid is required to cover the service, even if it’s not explicitly listed in the state plan.
Medical Necessity and Diagnosis
To access ABA therapy through Medicaid
- Your child must be under 21 years old
- Be enrolled in NC Medicaid
- Have a formal ASD diagnosis from a licensed provider (e.g., pediatrician, psychologist)
- Have a treatment plan that demonstrates
medical necessity
Prior Authorization Required
NC Medicaid requires
pre-authorization before ABA therapy can begin. The treatment plan must include:
- Diagnostic documentation
- Functional assessments
- Clearly defined goals and objectives
- Recommended service hours and frequency
We handle all of this for you to minimize stress and speed up approval.
Settings for Services
ABA therapy may be delivered in:
- The home
- Clinic-based settings
- Community or school environments, when appropriate
We’ll help you select the most appropriate and effective setting for your child’s needs.
How to Start ABA Therapy with Medicaid in North Carolina
We help guide you through every step of the process:
2. Get a Formal Autism Diagnosis
Your child must have a documented ASD diagnosis from a licensed professional. We can refer you to trusted providers if needed.
3. Start the Intake Process
Once you contact Blue Jay ABA, we’ll collect basic information and schedule an initial assessment with a Board Certified Behavior Analyst (BCBA).
4. We Handle the Authorization
We submit all required documents to Medicaid on your behalf, including your child’s diagnosis, assessments, and treatment plan.
5. Begin Services
We submit all required documents to Medicaid on your behalf, including your child’s diagnosis, assessments, and treatment plan.
Why Choose Blue Jay ABA?
We understand how confusing Medicaid can be. That’s why Blue Jay ABA:
Is an
approved NC Medicaid provider
Has experience with
all major Managed Care Plans
Offers
individualized care led by licensed professionals
Provides
full support with paperwork and authorizations
Delivers therapy in the
home, school, or community
We make high-quality ABA therapy accessible for every family — no matter where you are in your journey.
Frequently Asked Questions About NC Medicaid & ABA Therapy
Our ABA Therapy Insurance Partners
Start ABA Therapy with Medicaid Today
If your child is enrolled in North Carolina Medicaid, Blue Jay ABA is here to help them thrive. From diagnosis to daily therapy, we support your family every step of the way.
