How to Start an ABA Therapy Company: A Step-by-Step Checklist

This is the operational checklist. It assumes you've already decided you're doing this and roughly where. If you haven't, start with the decisions that actually matter.

Phase 1 — Legal and financial foundation

Choose your entity type and ownership structure with a healthcare attorney licensed in your state.
Register the entity and obtain your EIN.
Confirm any state-specific licensure or corporate-practice requirements for behavior analysis.
Open business banking and set up bookkeeping from day one, not "once we have revenue."
Bind professional liability, general liability, workers' compensation and cyber coverage.
Obtain your individual (Type 1) and organizational (Type 2) NPIs, with taxonomy codes that match how you'll bill.
Register with CAQH and keep the profile attested — several payers pull from it automatically.

Phase 2 — Payer access

List every payer that covers a meaningful share of children in your market.
Confirm which panels are currently open and which have closed-panel or reapplication windows.
Submit Medicaid enrollment and all commercial applications in parallel.
Assign one person to follow up weekly with every payer, in writing, with a tracked reference number.
Record each payer's expected timeline, actual timeline, effective date and revalidation date in one calendar.
Read your fee schedules before you sign, and know which codes require prior authorization.

Phase 3 — Systems

Select practice management, data collection and scheduling software for the company you'll be in eighteen months.
Set up a clearinghouse and confirm payer-specific claim requirements, modifiers and place-of-service codes.
Configure authorization tracking with lead-time alerts before units run out.
Write your documentation standards: assessment, treatment plan, session notes, supervision notes, parent training.
Confirm EVV requirements if your state or payer mandates them, and test the workflow before your first session.
Establish a weekly number set: scheduled hours, delivered hours, billed hours, collections, AR aging, open authorizations.

Phase 4 — People

Write job descriptions, offer letters and an employee handbook before your first hire, not after your first problem.
Confirm classification (employee vs. contractor) with counsel — this is a recurring source of expensive mistakes in ABA.
Build a supervision structure that satisfies both certification requirements and payer contract terms.
Design onboarding for the first ninety days specifically; that's when most RBT turnover happens.
Hire against approved authorized hours.

Phase 5 — Demand

Identify every diagnostician, pediatric practice, school district contact and parent network in your radius.
Build an intake process that answers a family within one business day and never loses a lead in an inbox.
Publish a website that says clearly what you do, who you serve, which insurance you take and how to start.
Track referral source on every intake so you know what's actually working within ninety days.

Phase 6 — First claim

Deliver the first session with documentation reviewed against your own standard before it's submitted.
Bill it within days, not weeks.
Confirm it paid — in full, at the contracted rate, with the right units.
Fix whatever broke before the second one, because whatever broke will break a hundred more times.

What to do differently from most founders

Three habits separate launches that reach stability quickly from launches that grind:

They treat credentialing as the critical path and manage it like a project with owners and dates.
They plan cash to a conservative revenue start date and hold reserve for a slip.
They install the weekly number set before there are numbers, so they can see problems while they're still small.

None of this is complicated. It is just a long list, and the cost of learning it in order — instead of by consequence — is most of your first year.