How to start an ABA practice in Pennsylvania

Pennsylvania requires a Licensed Behavior Specialist (individual); Intensive Behavioral Health Services (IBHS) agency license for ABA providers from Pennsylvania State Board of Medicine (behavior specialist license); Department of Human Services, Office of Mental Health and Substance Abuse Services (IBHS agency license) to operate an ABA practice. Fee: $75.

License required

Yes

License

Licensed Behavior Specialist (individual); Intensive Behavioral Health Services (IBHS) agency license for ABA providers

Issuing agency

Pennsylvania State Board of Medicine (behavior specialist license); Department of Human Services, Office of Mental Health and Substance Abuse Services (IBHS agency license)

Fee

$75

Fee details

Behavior specialist license application $75 (49 Pa. Code 16.13(i)). IBHS agency license fees not reviewed.

Renewal

Every 2 years · Behavior specialist biennial renewal $75; reactivation application $75.

Professional license

board: Pennsylvania State Board of Medicine (Behavior Specialist); statute: 49 Pa. Code §§ 18.521–18.527 (behavior specialist); 49 Pa. Code § 16.13 (fees); 55 Pa. Code ch. 5240 (IBHS); 55 Pa. Code ch. 1155 (MA payment for IBHS); behavior analyst: Pennsylvania licenses 'behavior specialists' (master's-level, with experience and 90 hours of coursework), not 'behavior analysts' by that title. For IBHS ABA, behavior analytic services require a PA professional license (behavior specialist, psychologist, LPC, etc.) plus BCBA-level certification.; assistant behavior analyst: No state assistant license. BCaBAs may deliver BHT-ABA or assistant behavior consultation within IBHS.; technician: No individual technician license, but IBHS rules (55 Pa. Code 5240.81(g)) require BHT-ABA staff to hold BCaBA, RBT, BCAT or other accredited certification, or have a high school diploma plus 40-hour RBT-task-list training certified by a BCBA/BCaBA trainer, or 2 years of ABA experience plus 40 hours of approved training.; agency or clinic license: Yes. Entities providing intensive behavioral health services, including ABA, to children, youth and young adults must hold a DHS IBHS license (55 Pa. Code ch. 5240). Medical Assistance pays for ABA under 55 Pa. Code ch. 1155 (e.g., 1155.33).; medicaid enrollment: Medical Assistance ABA is paid to licensed IBHS agencies meeting the 55 Pa. Code ch. 5240 staffing rules and the ch. 1155 payment conditions.

Regulation

49 Pa. Code §§ 16.13, 18.524; 55 Pa. Code §§ 5240.81–5240.83; 55 Pa. Code § 1155.33

1. Behavior specialist: hold a master's or higher in a listed field; have 1 year of FBA experience with people under 21 and 1,000 hours of clinical or autism-related experience; complete 90 hours of specified coursework or training (ethics, autism, assessment, instruction, crisis, comorbidity and more)
2. Apply to the State Board of Medicine ($75)
3. Agencies delivering ABA to children, youth or young adults: obtain an IBHS license from DHS under 55 Pa. Code ch. 5240
4. Staff the IBHS agency with a qualified administrative director and clinical director (licensed professional plus BCBA or graduate ABA credential)

Staffing

• IBHS ABA clinical director: PA-licensed professional (for example psychologist, LPC, LCSW or behavior specialist) with BCBA or other NCCA/ANSI-accredited graduate behavior-analysis certification, or a graduate degree or certificate in ABA (55 Pa. Code 5240.81)
• Behavior analytic services: PA-licensed professional (including behavior specialist) plus graduate-level behavior analysis certification

Training

• IBHS agencies providing ABA must ensure staff complete initial and annual training (55 Pa. Code 5240.83)

Program

Pennsylvania Medical Assistance (Medicaid) / HealthChoices, PA Department of Human Services, Office of Medical Assistance Programs

Enrollment portal

PROMISe Provider Portal — Electronic Provider Enrollment (PE) Application

Fiscal agent

PROMISe (DHS claims and enrollment system); the DHS electronic enrollment manual was prepared by Gainwell

Application fee

Since February 27, 2023, applicants pay the enrollment application fee described in MA Bulletin 01-16-14 ('ACA Enrollment Application Fee'). To claim an exemption, submit the documentation that bulletin describes. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.

Fingerprinting

High-risk providers must complete fingerprint-based criminal background checks; this requirement returned February 27, 2023 (MA Bulletin 99-16-13 sets the risk levels). If fingerprints are not submitted, the service location in PROMISe is closed. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Moderate- and high-risk providers get a site visit from DHS or its contractor (MA Bulletin 99-16-13). If the visit cannot confirm the application, for example because the location is not operating, or the provider does not cooperate, the service location is closed.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. DHS sends revalidation notices 90 and 30 days before the due date (MA Bulletin 99-16-10 has the details). The revalidation date is visible in ePEAP. A missed due date closes the service location in PROMISe, and the provider must then file a reactivation application.

Full Pennsylvania Medicaid enrollment guide →

CON program

No

Pennsylvania 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)

344 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

2,952,912 (as of Jun 1, 2026)

All Pennsylvania ABA Medicaid rates, ranked →

• PA Adult Autism Waiver (1915(c))
• PA Community HealthChoices Waiver (1915(c))
• PA Community Living Waiver (1915(c))
• PA Consolidated Waiver (1915(c))
• PA Medicaid Waiver for Infants, Toddlers and Families (1915(c))
• PA OBRA Waiver (1915(c))
• PA Person/Family Directed Support (P/FDS) Waiver (1915(c))

Pennsylvania waivers and waiting lists →