ABA Therapy Centers in New Jersey

NJ FamilyCare autism benefit under EPSDT

NJ FamilyCare covers services to treat autism under its Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. The benefit reaches Medicaid members under 21 who have an ASD diagnosis made by a qualified licensed practitioner. Services follow a recommendation from a physician, advanced practice nurse or psychologist. Behavior analysts deliver the ABA, with technicians working under a supervising BCBA.

• NJ FamilyCare helpline: 1-800-701-0710 (TTY 711)
• Your health plan (MCO) varies by county, so check which plans serve your county before you choose a clinic.

P.L. 2009, c.115 and private insurance

Chapter 115 (N.J.S.A. 17B:26-2.1cc and companion sections for each insurer type) requires covered contracts delivered, issued or renewed in New Jersey to pay for ABA when the member is under 21 and autism is the primary diagnosis. The benefit matches other medical coverage and carries no cap on visits. The dollar maximum started at $36,000 a year in 2011 and rises with the consumer price index. The last state notice we found set $37,710 for 2014, so ask your plan for this year's figure.

Children's System of Care and DDD supports

The DDD Supports Program and Community Care Program both require a person to be 21 or older. Children use the Children's System of Care, which PerformCare runs, and that eligibility ends the day before the 21st birthday. Plan ahead for the handoff: the state says there is no waiting list to enroll in the Supports Program, but a waiting list exists to be evaluated for the Community Care Program.

• PerformCare answers 24 hours a day at 1-877-652-7624.

New Jersey Early Intervention System

The state Department of Health runs the New Jersey Early Intervention System for infants and toddlers up to age three. If you suspect a delay, call 888-653-4463, a toll-free number for New Jersey residents. After an evaluation, the team writes an Individualized Family Service Plan and delivers services in settings such as your home. Families under three times the federal poverty level pay nothing for services.

Licensed Behavior Analysts in New Jersey

New Jersey licenses behavior analysts under the Applied Behavior Analyst Licensing Act (P.L. 2019, c.337). The State Board of Applied Behavior Analyst Examiners sits in the Division of Consumer Affairs. The law creates two license types: licensed applied behavior analyst and licensed assistant applied behavior analyst, who works under ongoing supervision. Ask any clinic for the supervising analyst's New Jersey license number.