How to start an ABA practice in Alabama

Alabama requires a Licensed Behavior Analyst (LBA); Licensed Assistant Behavior Analyst (LABA) from Alabama Behavior Analyst Advisory Council (Alabama Department of Mental Health) to operate an ABA practice. Fee: LBA: $25 nonrefundable application review fee + $150 licensure fee (plus background-check cost). LABA: $25 application review fee + $100 licensure fee. Temporary license: $25 + $100 for 90 days.

License required

Yes

License

Licensed Behavior Analyst (LBA); Licensed Assistant Behavior Analyst (LABA)

Issuing agency

Alabama Behavior Analyst Advisory Council (Alabama Department of Mental Health)

Fee

LBA: $25 nonrefundable application review fee + $150 licensure fee (plus background-check cost). LABA: $25 application review fee + $100 licensure fee. Temporary license: $25 + $100 for 90 days.

Renewal

Every 2 years · LBA $150 / LABA $100 per two-year period ending December 31; $50 late fee after December 15; $100 reinstatement fee.

Professional license

board: Alabama Behavior Analyst Advisory Council, Alabama Department of Mental Health; statute: Code of Ala. 1975, Title 34, Chapter 5A; Ala. Admin. Code ch. 580-5-30B; behavior analyst: LBA requires current BCBA certification, application, fees, and a fingerprint background check.; assistant behavior analyst: LABA requires current BCaBA certification plus proof of supervision by an Alabama LBA.; technician: No state license or registration for technicians. The rules exempt ABA direct contact technicians who work under the direction of an LBA or LABA, and the state says no license is required for RBTs. Medicaid covers RBT services when supervised by a BCBA or BCaBA.; medicaid enrollment: Alabama Medicaid enrolls ABA as an EPSDT-referred therapy provider (specialty 175) through its fiscal agent; the behavior analyst must be licensed by the state (licensed psychologists/psychiatrists may add the specialty). Services need a physician order. The service location must be a signed physical facility, not a home residence, cubicle or virtual office. Claims are billed by the BCBA.

Regulation

Code of Ala. 1975, §34-5A-1 et seq.; Ala. Admin. Code r. 580-5-30B; Ala. Admin. Code r. 560-X-11-.14 (EPSDT referred providers)

1. Obtain BCBA (or BCaBA) certification from the national certifying entity
2. Submit the state licensure application with application review fee and licensure fee
3. Complete the criminal background check with two fingerprint cards and pay its fee
4. Assistant applicants: submit a proof-of-supervision form signed by an Alabama LBA
5. Renew every two years by December 15 (licenses expire December 31)

Staffing

• LABA practice requires ongoing supervision by an Alabama-licensed behavior analyst
• Medicaid: BCaBAs and RBTs must be employed by a BCBA, who submits claims and assumes professional responsibility

Program

Alabama Medicaid

Enrollment portal

Alabama Medicaid Electronic Provider Enrollment Application Portal (AMMIS)

Fiscal agent

Gainwell Technologies (runs the Provider Enrollment Unit for the Alabama Medicaid Agency)

Application fee

Alabama collects the fee from new and re-enrolling institutional provider types on its fee list (e.g., ASCs, community mental health centers, DMEPOS suppliers, ESRD clinics, FQHCs), paid by certified or cashier's check to the Alabama Medicaid Agency; the agency's participation requirements document carries the current amount. Hardship exceptions can be requested through the fiscal agent. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Alabama says skilled nursing facilities were moved to the high/moderate risk tier at CMS's direction, and high-risk enrollment triggers a fingerprint-based criminal background check. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Alabama states SNFs get a site visit at initial enrollment and at each 5-year revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Alabama notifies providers when they are due and posts monthly lists of providers due for revalidation; a file closed for missing revalidation requires a brand-new application. Revalidations can be uploaded through the secure web portal. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Alabama Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Alabama State Health Planning and Development Agency (SHPDA); applications decided by the Certificate of Need Review Board

Services covered

• hospitals (general, specialized, psychiatric, long-term care)
• skilled nursing facilities
• intermediate care facilities
• rehabilitation centers
• ambulatory surgery facilities
• kidney disease treatment / freestanding dialysis
• community mental health centers
• alcohol and drug abuse facilities
• facilities for the developmentally disabled
• hospice
• home health agencies
• health maintenance organizations

Alabama certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Applied behavior analysis organizations — active organization NPIs (NPPES)

141 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

930,919 (as of Jun 1, 2026)

All Alabama ABA Medicaid rates, ranked →

• Community Transition (ACT) Waiver (1915(c))
• Community Waiver Program (1915(c))
• Home and Community-Based Waiver for the Elderly and Disabled (1915(c))
• Home and Community-Based Waiver for Persons with Intellectual Disabilities (1915(c))
• HCBS Living at Home Waiver for Persons with Intellectual Disabilities (LAH) Waiver (1915(c))
• SAIL Waiver (1915(c))
• Technology Assisted (TA) Waiver (1915(c))

Alabama waivers and waiting lists →