Does Medicaid Cover ABA Therapy in North Carolina?
Published April 8, 2026
Yes — North Carolina Medicaid covers ABA therapy for children and teens under 21 with an autism diagnosis. NC Medicaid went through a major transformation in 2023 with the launch of Tailored Plans — specialized managed care plans for people with behavioral health needs and disabilities, including autism. Here's how it all works.
Key takeaways
- NC Medicaid covers ABA for all children under 21 with autism
- Children with autism are enrolled in Tailored Plans — specialized MCOs for disabilities
- The main Tailored Plans are Cardinal Innovations, Trillium, Eastpointe, Alliance, and Partners
- NC has a strong commercial insurance autism mandate with no age limit
- Charlotte, Raleigh, and Greensboro have the largest provider networks
NC Medicaid Tailored Plans for autism
Children with autism in NC are typically enrolled in a Tailored Plan — managed care organizations that specialize in behavioral health, intellectual and developmental disabilities (I/DD), and traumatic brain injury. The Tailored Plans operating in NC are:
- Alliance Health — Durham, Wake, Cumberland, Johnston, Chatham counties
- Cardinal Innovations Healthcare — 20+ counties in the Piedmont region
- Eastpointe — eastern NC counties
- Partners Health Management — western Piedmont and Foothills
- Trillium Health Resources — northeastern NC counties
- Vaya Health — western NC mountain region
Your assigned plan depends on your county. Visit nccarelink.gov to find your local plan.
NC commercial insurance autism mandate
North Carolina's autism insurance law (Session Law 2015-286) requires fully-insured commercial health plans to cover ABA therapy with no age limit and no annual dollar cap. If your child has private insurance, your plan must cover ABA under NC law.
How to access ABA through NC Medicaid
- Find your Tailored Plan. Visit nccarelink.gov or call NC Medicaid at 1-888-245-0179.
- Get an autism diagnosis from a licensed psychologist, developmental pediatrician, or psychiatrist.
- Contact your Tailored Plan to get a list of in-network ABA providers in your county.
- Complete intake and assessment. The BCBA submits a treatment authorization request.
- Authorization typically takes 7–14 days. Therapy begins at no cost.
NC resources
- NC Medicaid: medicaid.ncdhhs.gov
- NC Care Link: nccarelink.gov
- Autism Society of NC: autismsociety-nc.org
- NC Medicaid helpline: 1-888-245-0179
Find North Carolina ABA providers that accept Medicaid
FindABA lists ABA providers across North Carolina with accepted insurance plans including Tailored Plans and NC Medicaid.
Search North Carolina providers →