Insurance Guide · North Carolina (NC)
ABA Therapy Insurance in North Carolina
Annual Cap
No annual cap
Age Limit
No age limit
Plan Types
Individual and group fully-insured plans
North Carolina Mandate Details
Mandate Law
S.L. 2015-97 (2015)
Year Enacted
2015
Medicaid Coverage in North Carolina
North Carolina Medicaid covers ABA therapy for children under 21 with an autism diagnosis through EPSDT.
What to Know About ABA Coverage in North Carolina
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.
Frequently Asked Questions
Does North Carolina require insurance to cover ABA therapy?
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.
Does North Carolina Medicaid cover ABA therapy?
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.
Where are ABA providers concentrated in North Carolina?
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
Need help navigating ABA insurance?
Our team works with ABA providers across North Carolina.