North Carolina has no annual cap under the S.L. 2015-97 (2015). Here's what families and operators need to know.
No annual cap · S.L. 2015-97 (2015)Updated April 2026S.L. 2015-97 (2015)
2015
North Carolina Medicaid covers ABA therapy for children under 21 with an autism diagnosis through EPSDT.
North Carolina's mandate has no annual dollar cap and no age limit. The Research Triangle (Raleigh-Durham-Chapel Hill) and Charlotte areas have particularly strong ABA provider networks.
Yes. North Carolina's S.L. 2015-97 requires fully-insured plans to cover ABA therapy for individuals with autism with no annual dollar cap and no age limit.
Yes. North Carolina Medicaid covers ABA therapy for children under 21 through EPSDT. The state transitioned to Medicaid managed care (NC Medicaid Managed Care), which coordinates ABA services.
ABA providers are concentrated in the Research Triangle (Raleigh-Durham-Chapel Hill), Charlotte, and the Triad (Greensboro-Winston-Salem). Rural eastern and western North Carolina have fewer providers but telehealth is expanding.
Higglo works with ABA providers across North Carolina on marketing, intake, and growth. Talk to our team about your program.
