Bringing a diagnosing psychologist or physician in-house forces licensee ownership. Flip: separate licensee-owned diagnostic entity plus a management company.
Who may give the diagnosis in Tennessee
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 Tennessee treats psychology and medicine ownership
Tennessee's learned-professions doctrine bars an ordinary entity from employing physicians, and a professional limited liability company may include non-licensee members only if the licensing board authorizes it, and may render only a single profession. That channels psychology into a licensee-owned entity.
What bringing the diagnostician in-house does
Bringing a diagnosing psychologist or physician in-house forces licensee ownership. Flip: separate licensee-owned diagnostic entity plus a management company.
How to structure it in Tennessee
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 Tennessee code, the applicable federal safe harbor, and qualified healthcare-regulatory and tax counsel are the authoritative sources.