North Carolina enacts new Medicaid ABA telehealth and supervision rules

North Carolina House Bill 696, enacted as Session Law 2026-1 and signed by the Governor on April 30, 2026 (ratified April 28, 2026), directs the Division of Health Benefits to amend NC Medicaid Clinical Coverage Policy 8F, in Section 3C.18, "Medicaid Coverage for ABA Therapy." Under the act, services under CCP-8F provided by a paraprofessional may not be conducted via telehealth unless exceptions are developed, and patient assessments by Licensed Qualified Autism Service Providers, LQASPs, are required to be conducted in person. LQASP telehealth that observes and directs a paraprofessional may not comprise more than fifty percent of the LQASP's services for any recipient unless exceptions apply, and at least ten percent of all CCP-8F services a paraprofessional provides must involve observation and direction by a LQASP. Board Certified Behavior Analysts and Qualified Autism Services Practitioner Supervisors are not permitted to enroll in NC Medicaid as out-of-state providers. For noncompliance, the Division may recoup payments, and a third occurrence of material and systematic noncompliance can suspend billing eligibility for one to two years.

Who it affects. Every ABA practice billing NC Medicaid under Clinical Coverage Policy 8F is affected, particularly a practice that uses telehealth for paraprofessional-delivered services or for LQASP supervision, and any Board Certified Behavior Analyst or Qualified Autism Services Practitioner Supervisor who is not a North Carolina-based provider. The act's text states that the out-of-state enrollment subsection "is effective when it becomes law and applies to all applications for enrollment submitted on or after that date," and that the remainder of the section "is effective when it becomes law."

We did not confirm whether the Division of Health Benefits has amended Clinical Coverage Policy 8F since enactment, and this dossier states no dollar figure or rate. Check NC Medicaid directly for the current version of Clinical Coverage Policy 8F before relying on any telehealth percentage or supervision figure for billing. See the North Carolina Medicaid and insurance page for the state's broader coverage picture and the Medicaid and insurance hub for how Medicaid enrollment and billing work across states.