How to start an ABA practice in Delaware

Delaware does not require a state license for an ABA practice, according to None for licensure. DHSS sets 'qualified autism service provider' standards (16 DE Admin. Code 2102). Medicaid ASD services: DHSS Division of Medicaid and Medical Assistance (DMMA).. No state behavior analyst license — Delaware certifies autism service providers by BACB credential (16 DE Admin. Code 2102).

License required

No

Issuing agency

None for licensure. DHSS sets 'qualified autism service provider' standards (16 DE Admin. Code 2102). Medicaid ASD services: DHSS Division of Medicaid and Medical Assistance (DMMA).

Professional license

statute: 16 Del. Admin. Code 2102 (Autism Service Providers), adopted under 18 Del. C. §§ 3361(f) and 3570A; behavior analyst: Delaware has no behavior analyst licensure law. Under 16 DE Admin. Code 2102, current BCBA or BCBA-D certification by itself qualifies a person to provide ABA for insurance-mandate purposes, and losing the BACB credential disqualifies the provider.; assistant behavior analyst: No state license. BCaBAs may work under supervision and count as meeting the technician competency-training requirement.; technician: No state license or registration, but the state sets minimum standards for 'behavioral technicians' (16 DE Admin. Code 2102 §3.3), verified by the supervising BCBA. Under the Medicaid ASD state plan language, unlicensed staff must hold BCaBA or RBT certification.; medicaid enrollment: DMMA covers EPSDT Autism Spectrum Disorder treatment, including ABA, for members under 21 as a preventive service with prior authorization by DMAP or its designee. Under the state plan language, qualified practitioners must hold BACB certification (BCBA/BCBA-D, or BCaBA/RBT under a BCBA). Licensed practitioners such as LCSWs, LPCMHs, psychologists and physicians must also be BACB certified to deliver ABA.

Regulation

16 Del. Admin. Code 2102; Delaware Medicaid State Plan Att. 3.1-A, 13.c (ASD services), DMMA Reg. #16-008

1. Hold BCBA or BCBA-D certification; this alone qualifies a provider for ABA under 16 DE Admin. Code 2102
2. Have the supervising BCBA verify that each behavioral technician meets the 2102 section 3.3 criteria
3. For Medicaid, deliver EPSDT ASD services with prior authorization from DMAP or its designee

Staffing

• Behavioral technicians work under BCBA/BCBA-D supervision at no less than 1.5 supervision hours per 10 direct hours per week (minimum 1 hour/week if under 10 hours are delivered)

Training

• Behavioral technician: high school diploma/GED
• Federal and state criminal background check plus child and adult abuse registry check
• Annual CPR certification
• Signed statements on Delaware child-abuse reporting law and HIPAA
• Course on autism spectrum disorders
• Competency-based ABA training verified by the BCBA (BCaBA holders are deemed to meet this)
• Course on ABA principles
• At least 10 hours of observed competency training and direct service before one-on-one work

Program

Delaware Medical Assistance Program (DMAP) / Diamond State Health Plan

Enrollment portal

DMAP Provider Portal — Provider Enrollment

Fiscal agent

Gainwell Technologies (DMAP provider portal and Provider Relations/enrollment help desk)

Application fee

DMAP states that from January 1, 2026, institutional providers pay $750 at initial application, reactivation, revalidation, re-enrollment and when adding a location. Its screening-level lists mark which taxonomies owe the fee; hardship exceptions go to CMS. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

DMAP publishes taxonomy screening-level lists (limited/moderate/high) for fee-for-service and managed-care-only providers; the high-risk taxonomies on those lists are subject to fingerprinting. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Risk levels for site-visit purposes follow DMAP's published taxonomy screening-level lists. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

DMAP mails revalidation instructions 60 days before the due date and terminates providers who miss it; it warns that CMS is requiring many providers to revalidate within the next 24 months. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Delaware Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Public Review (CPR)

Agency

Delaware Health Resources Board, staffed by the Bureau of Health Planning and Resources Management (Department of Health and Social Services)

Services covered

• hospitals
• nursing homes
• freestanding surgical centers
• freestanding birthing centers
• freestanding acute inpatient rehabilitation hospitals
• freestanding emergency centers
• capital expenditures above $5.8 million (inflation-adjusted)
• bed capacity changes of more than 10 beds or 10% (whichever is less) over 2 years
• acquisition of a nonprofit health-care facility

Moratoria

Until July 1, 2028, only charities / not-for-profit entities may apply for a Certificate of Public Review to build, establish or acquire an acute care hospital; the Board may not accept other applicants (16 Del. C. §9304(b), added by 85 Del. Laws c. 350).

Delaware certificate of need details →

State minimum wage

$15.00 an hour

Effective

2025-01-01

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)

56 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

234,783 (as of Jun 1, 2026)

All Delaware ABA Medicaid rates, ranked →

• Diamond State Health Plan Plus (DSHP-Plus) — managed LTSS under the DSHP Section 1115 demonstration (1115)
• DDDS Lifespan Waiver (1915(c))

Delaware waivers and waiting lists →