Yes, under the North Carolina autism insurance mandate (established by Senate Bill 676), many state-regulated private health plans include an annual coverage cap for Applied Behavior Analysis (ABA) therapy. We help families navigate these regulations, which typically include a $40,000 annual coverage cap for children up to age 18.

It is important to note that while this mandate applies to many private group plans with 15 or more employees, it does not apply to self-funded ERISA plans. Additionally, coverage details can vary based on your specific provider and plan type. Because of mental health parity laws in North Carolina, insurers must provide ABA benefits that are comparable to other medical services, ensuring your child receives high-quality ABA therapy without facing disproportionate limitations.

To help you maximize your benefits, we offer a white-glove service that includes:

• Free insurance verification: We typically confirm benefits within 24–48 hours.
• Prior authorization management: Our BCBA-led team handles the paperwork and communication with your insurer.
• Transparent pricing: We provide clear information so you understand potential out-of-pocket costs before starting services.

Insurance coverage varies by plan — verify benefits with your insurer before starting services. Results may vary and individual outcomes are not guaranteed. Consult your licensed BCBA or healthcare professional for individualized assessment and recommendations.

• North Carolina Autism Insurance Mandate: Complete Guide for Families