Starting your own ABA therapy practice is one of the most rewarding career moves a BCBA can make. You set your own schedule, choose your clients, and build something that's truly yours. But the business side — billing, compliance, technology — can feel overwhelming.
This guide walks you through everything: from getting your NPI to submitting your first insurance claim. No fluff, just the steps.
Step 1: Get Your Business Foundations in Order
Before you see your first client, you need:
Business Entity
- LLC is the most common choice for solo BCBAs (liability protection + tax flexibility)
- File with your state's Secretary of State ($50-500 depending on state)
- Get an EIN (Employer Identification Number) from the IRS — free, takes 5 minutes online
NPI Number
- Apply at NPPES — free, takes 1-2 weeks
- You need a Type 1 NPI (individual provider)
- This 10-digit number goes on every insurance claim you submit
Professional Liability Insurance
- Coverage: $1M per occurrence / $3M aggregate is standard
- Cost: $300-600/year for a solo BCBA
- Providers: HPSO, Mercer, Proliability
Step 2: Set Up Your Billing Infrastructure
This is where most solo BCBAs get stuck. Insurance billing has a lot of moving parts.
Credential with Insurance Payers
- This takes 60-120 days — start immediately
- Apply to each payer you want to accept (BCBS, Aetna, UnitedHealthcare, Cigna, Medicaid)
- You'll need: NPI, Tax ID, BACB cert, liability insurance, business address
- Consider using a credentialing service ($500-1500) if you don't want to do it yourself
Get a Clearinghouse Account
- A clearinghouse is the intermediary between you and insurance companies
- Office Ally is popular for solo practices ($35/month per provider)
- They handle 837P claim submission and 835 payment posting
Choose Practice Management Software
You need: data collection, session notes, scheduling, billing, and claims. Prices range from $39/user/month to $150+/user/month. For a solo practice, look for:
- Self-serve signup (no sales calls)
- Built-in clearinghouse integration
- AI-powered session notes (saves 4+ hours/week)
- Insurance authorization tracking
- Parent portal (differentiates your practice)
ABA CPT Codes You'll Use
| Code | Description | Typical Rate |
|---|---|---|
| 97151 | Behavior assessment | $120-180/hour |
| 97153 | Adaptive behavior treatment (RBT direct) | $50-80/unit |
| 97155 | Adaptive behavior treatment (BCBA direct) | $80-120/unit |
| 97156 | Caregiver training | $80-120/unit |
| 97158 | Group adaptive behavior treatment | $40-60/unit |
Units: 1 unit = 15 minutes. An 8-hour session = 32 units.
Step 3: Find Your First Clients
Referral Sources
- Pediatricians — introduce yourself, leave business cards and brochures
- Schools — school psychologists and special education directors refer families
- Autism advocacy organizations — Autism Speaks, local autism societies
- Other BCBAs — BCBAs with full caseloads refer overflow clients
- Parent Facebook groups — "Autism Parents of [Your City]"
Digital Intake Process
Create a digital intake form that families can fill out online. Collect: child demographics, diagnosis, insurance info, parent concerns, therapy goals. Modern platforms let you share a public intake link — families submit, you review with AI analysis that suggests initial programs and targets.
Step 4: Clinical Setup
Assessment
- Complete an initial assessment (VB-MAPP, ABLLS-R, or similar)
- Write an assessment report with treatment recommendations
- Submit for authorization (most payers require prior auth for ABA)
Authorization
- Authorization = insurance approval to provide services
- Typically 6 months, with a specific number of units approved
- Track units carefully — if you exceed the authorization, you won't get paid
- Set up alerts for authorizations expiring within 30/60/90 days
Step 5: Hire Your First RBT (When Ready)
When to Hire
- When your caseload exceeds what you can directly serve
- When you have enough authorized hours to keep an RBT busy (20+ hours/week)
- When you can cover payroll for at least 2 months
Supervision Requirements
- You must provide at least 5% of each RBT's direct service hours as supervision
- Document every supervision session (date, duration, topics, fidelity score)
- Monthly supervision summaries for BACB compliance
Step 6: Operations & Compliance
HIPAA Compliance
- Use HIPAA-compliant software for all client data
- Have clients sign HIPAA Notice of Privacy Practices
- Implement a breach notification plan
- 30-minute session timeout on all devices
Documentation Requirements
- Session notes within 24 hours of each session
- Dual signature (RBT + BCBA) on every note
- Insurance-ready SOAP format
- No mentalistic language ("seemed frustrated" → "engaged in vocal protests for 3 minutes")
The Numbers: What to Expect
| Scenario | Monthly Revenue |
|---|---|
| 5 clients, 10 hrs/week direct | $4,000-6,000 |
| 8 clients, 15 hrs/week + 1 RBT | $8,000-12,000 |
| 10 clients, 2 RBTs, you supervise | $12,000-20,000 |
| Monthly Expense | Cost |
|---|---|
| Liability insurance | $40 |
| Practice management software | $39-79 |
| Clearinghouse (Office Ally) | $35 |
| Phone/internet | $100 |
| Marketing | $50-200 |
| Total (solo) | $300-500/month |
Most solo BCBAs break even within 2-3 months if they start with at least 3 clients and have insurance credentials in place.
Ready to Start?
The hardest part is making the decision. Everything else is logistics.
Start your practice today with LearnLoop ABA — auto-creates your clinic, sets up your billing identity, and lets you schedule your first session in under 10 minutes.
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