The diagnosis has to sit in its own licensee-owned professional entity. Flip, trending split: diagnosis cannot share the ABA entity.
Who may give the diagnosis in North Carolina
The medical-necessity diagnosis is made by a licensed physician or a licensed psychologist. A BCBA may not diagnose ASD, so the diagnostician you would bring in-house is a psychologist or a physician, and both are professions the state may treat differently from behavior analysis.
How North Carolina treats psychology and medicine ownership
North Carolina strictly enforces the corporate-practice doctrine. A psychology practice must be a professional corporation registered with the Psychology Board whose shareholders are only permitted licensees, and psychology is an enumerated professional service. Because ABA is an ordinary LLC and psychology requires a licensee-owned professional entity, the two cannot share one entity.
What bringing the diagnostician in-house does
The diagnosis has to sit in its own licensee-owned professional entity. Flip, trending split: diagnosis cannot share the ABA entity.
How to structure it in North Carolina
Keep the ABA entity ABA-only and non-licensee owned, and put the diagnosis in a separate licensee-owned entity connected through a management company on fair-market-value, not volume-based, terms so the referral survives the federal Anti-Kickback Statute; or rely on an outside referral with no remuneration flowing for the referral. If the diagnostician is a physician and the payer is Medicaid, the federal physician self-referral rules add a layer that a psychologist does not trigger. The full three-entity structure is set out in the diagnostician question hub.
The corporate-practice, professional-entity, and anti-kickback rules summarized here are amended and reinterpreted, and verbatim text is a starting point rather than a conclusion. The official North Carolina code, the applicable federal safe harbor, and qualified healthcare-regulatory and tax counsel are the authoritative sources.