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Medicaid ABA Therapy

ABA Therapy with NC Medicaid in
North Carolina

If your child or young adult is enrolled in NC Medicaid, ABA therapy may be fully covered through your Medicaid Tailored Plan. iCare Therapy is an enrolled NC Medicaid provider serving families across North Carolina. Our care coordinators handle prior authorization, renewals, and every step of the Medicaid process.
Apply for Medicaid-Covered ABA Therapy
Call (800) 264-1985

Accepting Trillium

Alliance

Partners

Vaya

Eastpointe Tailored Plans

Tell us about your family.

Share whatever you’re comfortable with — our care coordinators will follow up to talk through services, scheduling, and next steps.

Your information is private and only used to respond to your inquiry.

Insurances We Accept

Understanding NC Medicaid for ABA

NC Medicaid Covers ABA Therapy - But Navigating It Can Be Overwhelming

NC Medicaid's Tailored Plan system is newer and many families don't know how to use it.

North Carolina transitioned to a managed care Medicaid model with regional Tailored Plans in 2023. Understanding which plan your family is enrolled in, how to access ABA benefits, and who your care manager is can feel confusing without guidance.

Prior authorization requirements can delay care significantly.

NC Medicaid requires prior authorization for ABA therapy. Without experience with the process, families may wait weeks or face denials due to incomplete documentation. iCare’s team knows exactly what each Tailored Plan requires.

Families aren't always told that under-3 children can start without a diagnosis.

One of the most important and underused facts about NC Medicaid is that children under 3 can access early intervention services – including ABA – under Medicaid before a formal autism diagnosis. Many families don’t learn this until it is too late.
How iCare Works with NC Medicaid

iCare Therapy Manages the Medicaid Process for Your Family

iCare Therapy is an enrolled provider with all NC Medicaid Tailored Plans. Our care coordinators have deep expertise in the NC Medicaid ABA authorization process and manage every step on your behalf. From your first call to ongoing renewals, we make sure your Care Recipient’s Medicaid benefits are used to their fullest.

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Enrolled provider with all NC Medicaid Tailored Plans

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Prior authorization managed by iCare's experienced team

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Renewals and re-authorization handled before coverage lapses

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Guidance on Innovations Waiver as a complementary resource

autism therapy charlotte nc
NC Medicaid Tailored Plans

NC Medicaid Tailored Plans Accepted by iCare Therapy

Trillium Health Resources

Trillium serves families in 24 eastern and northeastern NC counties. iCare is an enrolled Trillium provider. Member Services: (877) 685-2415.

Alliance Health

Alliance serves Durham, Johnston, Wake, and Orange counties in the Triangle area. iCare is an enrolled Alliance provider. Member Services: (800) 510-9132.

Partners Health Management

Partners serves families in Anson, Cabarrus, Davidson, Rowan, Stanly, and Union counties. iCare is an enrolled Partners provider. Member Services: (888) 235-4673.

Vaya Health

Vaya serves families in 24 western and northwestern NC counties. iCare is an enrolled Vaya provider. Member Services: (800) 849-6127.

Eastpointe

Eastpointe serves families in 6 counties in eastern NC. iCare is an enrolled Eastpointe provider. Member Services: (800) 913-6109.
Medicaid FAQ

Frequently Asked Questions - NC Medicaid and ABA Therapy

Does NC Medicaid cover ABA therapy?

Yes. NC Medicaid covers ABA therapy for eligible children and young adults through the Tailored Plan managed care system. The EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit covers medically necessary ABA services for Medicaid-enrolled individuals under 21.
Children under 3 enrolled in NC Medicaid may be able to access early intervention ABA services before a formal diagnosis through the CDSA (Children’s Developmental Services Agency) system. For children 3 and older, a formal ASD diagnosis is generally required for ABA authorization.
Call NC Medicaid Direct at (888) 245-0179 or check your Medicaid card. The plan name should be listed on your card. You can also ask your pediatrician’s office.
Prior authorization timelines vary by Tailored Plan but typically range from 5 to 15 business days. iCare’s team submits complete documentation to minimize delays. We begin the process as soon as your enrollment is confirmed.
The NC Innovations Waiver provides additional community-based services for individuals with intellectual and developmental disabilities who meet eligibility criteria. It has a waitlist. It is worth applying early even if you do not need it immediately. iCare can guide you through the application process.
iCare’s care coordinators manage renewal submissions in advance of every authorization expiration. Your family will be notified of upcoming renewals and we handle the re-authorization documentation with your BCBA.
iCare can provide guidance on the NC Medicaid application process, but we do not submit applications on families’ behalf. County DSS offices and NC DHHS handle enrollment. Our team can point you to the right resources.

NC Medicaid Covers ABA Therapy
- Let iCare Help Your Family Access It

Do not let paperwork or confusion about your Tailored Plan stand between your child and the care they deserve. iCare’s care coordinators know the NC Medicaid system and are ready to guide your family through every step.

Apply for Medicaid-Covered ABA
Call (800) 264-1985

Enrolled with all NC Medicaid Tailored Plans

EPSDT covered services

Statewide coverage