Profitability

How do clients pay for services?

States with Autism Insurance Reform

Most ABA facilities are paid directly by health insurance carriers. In fact, most states have laws that mandate publicly funded health plans to cover ABA as an Autism treatment.

 

In 2014, the APBA reported that private health insurance paid for 42% of all ABA services, followed by TRICARE at 21%, and public health plans (Medicaid and Medicare) at 22.5%.

 

SOS Franchising will assist you in securing in-network contracts with local health insurance carriers. We will also help you negotiate your contracted rates in order to maximize profit. We will also teach you how to submit claims to health insurance carriers for services rendered.

Reimbursement rates vary based on the insurance carrier and location. Rural areas (which tend to have severe provider shortages) may get higher rates than urban areas.

 

In fall 2014, state Medicaid reimbursed providers between $25 to $75/hr for a RBT and $55.50 to $125/hr for a BCBA.

 

In 2013, private insurance carriers reimbursed providers between $24.64 to $160 /hour for a RBT and $36.90 to $196.50 /hr for a BCBA.

 

In May 2019, Tricare reimbursement rates are up to $76/hr for a RBT and $135/hr for a BCBA.

health insurance
What kind of expenses will I have?

Payroll will be your biggest expense. Below are the average hourly rates for ABA organizations as reported by the BHCOE in 2018.

Average Hourly Rate for BCBAs
Average hourly rate for bcbas
average hourly rate of bcbas
Average Hourly Rate for RBTs
RBT average hourly rate
average hourly rate for rbts