The choice between in-house and agency ABA marketing usually comes down to three factors: budget threshold, internal expertise breadth, and time-to-impact urgency.
In-house works when the practice can fund a full-time marketer (loaded cost typically $90–140k for a senior generalist) and the role can stay focused on ABA-specific work. Agencies are appropriate when the practice needs cross-discipline expertise (SEO + GEO + CRO + paid + content) faster than it can be assembled internally, or when total marketing spend is below the threshold that justifies a full-time hire.
Hybrid models — in-house owner with agency execution support — are common in mid-size multi-site practices.