How to start an ABA practice in South Carolina

South Carolina does not require a state license for an ABA practice, according to None for licensure. Medicaid ABA: South Carolina Department of Health and Human Services (SCDHHS).. No state behavior analyst license — South Carolina; Medicaid ASD/ABA requires BACB credentials per the state plan.

License required

No

Issuing agency

None for licensure. Medicaid ABA: South Carolina Department of Health and Human Services (SCDHHS).

Professional license

behavior analyst: South Carolina has no behavior analyst licensure law. No SC licensing board for behavior analysts was found. SCDHHS ties ABA provider qualifications to BACB credentialing through the ASD Medicaid State Plan.; assistant behavior analyst: No state license; BACB BCaBA credential for Medicaid.; technician: No state license or registration, but Medicaid and BabyNet require direct ABA staff to be BACB-credentialed (RBT: 18+, high school diploma, 40-hour training, supervised). Providers using non-credentialed staff must coordinate transitions.; medicaid enrollment: Healthy Connections Medicaid ASD services follow the ASD Medicaid State Plan qualifications. Since October 1, 2019, IDEA Part C (BabyNet) ABA supervisory and direct therapy providers must meet the same BACB-based qualifications.

Regulation

South Carolina Medicaid State Plan — Autism Spectrum Disorder services

1. Hold BACB credentials: BCBA-D or BCBA to supervise; BCaBA or RBT for direct therapy
2. Enroll as a Healthy Connections Medicaid provider and meet the Autism Spectrum Disorder state plan provider qualifications
3. BabyNet (IDEA Part C) ABA providers must meet the same qualifications (since October 1, 2019)

Staffing

• BCaBAs are supervised by a BCBA-D or BCBA; RBTs by a BCBA-D, BCBA or BCaBA, and the supervisor is responsible for their work

Program

Healthy Connections Medicaid (South Carolina Department of Health and Human Services, SCDHHS)

Enrollment portal

SCDHHS online Provider Enrollment web application

Application fee

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. SCDHHS's enrollment page does not list a separate state fee.

Fingerprinting

High-risk providers must submit fingerprints and/or have a physical site visit. If fingerprinting runs past the 30-day revalidation deadline, sending a copy of the fingerprint appointment confirmation with the other documents prevents termination. 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

SCDHHS screening includes site visits where applicable, and high-risk providers may get a physical site visit at revalidation. Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections.

Revalidation

Since June 1, 2026, high-risk providers (federal or state-designated) revalidate every year and all others every three years, more often than the federal minimum. Under a CMS-approved two-year strategy, everyone first enrolled before June 1, 2025 will be revalidated. A rapid cohort covers opioid treatment programs, DME, home health, hospice, nursing facilities, private RBHS, independent licensed behavioral health practitioners, BCBAs/BCaBAs and HCBS providers. Wait for a notification letter with a revalidation number, then submit online within 30 days. Missing the deadline counts as voluntary termination.

Full South Carolina Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (State Certification of Need and Health Facility Licensure Act)

Agency

South Carolina Department of Public Health, Certificate of Need Program

Services covered

• nursing homes: new facilities, bed additions or licensure reclassification, and capital expenditures above the regulatory threshold
• hospitals: construction or establishment of a new hospital, and bed additions or reclassification (only until January 1, 2027)

South Carolina 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)

231 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

958,052 (as of Jun 1, 2026)

All South Carolina ABA Medicaid rates, ranked →

• SC Community Choices Waiver (1915(c))
• SC Community Supports (CS) Waiver (1915(c))
• SC Head and Spinal Cord Injury (HASCI) Waiver (1915(c))
• SC HIV/AIDS Waiver (1915(c))
• SC Intellectual Disability and Related Disabilities (ID/RD) Waiver (1915(c))
• SC Mechanical Ventilator Dependent Waiver (1915(c))
• SC Medically Complex Children Waiver (1915(c))

South Carolina waivers and waiting lists →