South Carolina ABA Therapy 2026: New School Law and July Medicaid Telehealth Changes
Published August 14, 2026
•
7 min read
Two significant changes are taking effect for South Carolina families who rely on ABA therapy for a child with autism. A new state law signed in May now gives parents the right to bring a private ABA therapist into their child's school during the school day. And starting July 1, 2026, South Carolina Medicaid is updating its telehealth rules in ways that will affect which services can be delivered remotely and which require an in-person visit.
If you have a child receiving or seeking ABA therapy in South Carolina, here is what you need to know about both changes.
A New Law Opens School Doors to Private ABA Providers
Governor Henry McMaster signed House Bill 3974 into law as Act No. 186 on May 18, 2026, effective the same day. The law requires public school districts in South Carolina to consider parent requests for ABA therapy services provided by private, licensed professionals during the school day.
Under H.3974, districts must evaluate those requests individually using an Americans with Disabilities Act (ADA) framework. This is an important distinction. In the past, a district could deny a parent's request simply by pointing to the child's existing Individualized Education Program (IEP). Under the new law, having an IEP in place is no longer a sufficient reason to block a private ABA provider from working with a child at school.
A district can still deny a request, but only if granting it would create an "undue burden" or "fundamental alteration" to school operations. That is a high legal threshold.
Who Can Provide Services Under This Law
The law covers services provided by licensed BCBAs (Board Certified Behavior Analysts), BCaBAs (Board Certified Assistant Behavior Analysts), BCBA-Ds (doctoral-level certification), and RBTs (Registered Behavior Technicians) supervised by a BCBA. All providers must meet South Carolina's licensure requirements.
When Will Schools Be Ready to Accept Requests
The bill text sets the timeline: "The board shall finalize its model policy by January 6, 2027," and districts "must adopt the model policy or develop their own policy that meets the minimum requirements of the model policy and is subject to department approval by July 1, 2027." That means full implementation is still roughly a year away, but the legal right exists now. Parents can begin requesting private ABA services under the ADA framework today, and districts must consider those requests individually.
How to Use H.3974 to Request ABA Services at Your Child's School
Because the state model policy is not yet finalized, school districts may not have a standard intake process in place. Here are practical steps families can take now:
- Put your request in writing. Submit a written letter to your child's principal and special education director requesting that a private, licensed ABA provider be permitted to deliver services during the school day. Reference H.3974 and the ADA framework.
- Frame the request as medically necessary. Attach documentation from your child's physician and BCBA explaining why the services are medically necessary and why school hours are clinically appropriate.
- Ask for a written response. Request that the district respond in writing within a specific timeframe. Fourteen to 30 days is a reasonable window.
- If you are denied, ask for the specific basis for denial and whether the district applied the ADA "undue burden" standard. A district that denies without applying that standard may be acting inconsistently with the law.
- Contact the SC Department of Education if you need further guidance while the model policy is being developed.
July 1, 2026 Medicaid Changes: Telehealth Rules Are Shifting
South Carolina Medicaid (SCDHHS) issued a new Autism Spectrum Disorder (ASD) Services Provider Manual dated July 1, 2026. The most significant change for families involves which ABA services can be delivered via telehealth and which now require an in-person visit.
CPT 97151 (Behavior Identification Assessment): No Longer Allowed via Telehealth
The manual is blunt about this: the Behavior Identification Assessment "is administered in-person with the member and caregiver" and "cannot be completed via telehealth." Reporting for 97151 includes direct observation in the child's natural environment and in all settings where ABA is requested, which is difficult to replicate through a video screen.
What this means for your family: if your child is starting the ABA process or needs a reassessment, you will need to schedule an in-person evaluation with a BCBA.
CPT 97155 (BCBA-Delivered Treatment Sessions): Now Telehealth-Eligible With Prior Authorization
The manual says 97155 is administered directly by a BCBA-D, BCBA or BCaBA in person with a single member, and that the enrolled provider "is expected to provide this direct service in-person." Telehealth is possible but constrained: "97155 will not be reimbursed through telehealth on a routine basis and not without prior authorization." Remote delivery uses the GT modifier and requires prior authorization through Acentra, South Carolina's quality improvement organization, so ask your provider whether they have obtained it before assuming a session can be virtual.
CPT 97156 (Family Guidance and Parent Training): Permanently Telehealth-Eligible
The manual states that family adaptive behavior treatment guidance "may be delivered by telehealth, using the GT modifier." It is also not optional: at least one hour of family guidance must be rendered during each month of authorized and rendered direct treatment and protocol modification services, to support generalization of skills between settings and to validate continuation of ABA services. The frequency limit is up to 96 units per 12 months per member, with a required minimum of 4 units per month and no more than 16 units billed per date of service. That telehealth flexibility matters for working parents and families in rural parts of the state.
What Stays the Same After July 1
The telehealth changes do not affect every aspect of ABA coverage in South Carolina. Here is what remains in place:
- Autism diagnosis requirements: A child must have a Comprehensive Diagnostic Assessment (CDA) conducted in person by a physician, psychologist, or licensed professional educational specialist. The assessment must use one of three validated tools: the ADI-R, ADOS, or CARS.
- Service limits: Per the manual's frequency limits table, CPT 97153 (direct treatment by protocol) is allowed up to 160 units per week per member, not to exceed 32 units per date of service. CPT 97155 (protocol modification) is to be rendered at up to 10 percent of rendered 97153 therapy hours, up to 64 units per month per member, not to exceed 16 units per week.
- Authorization periods: The manual refers to a six-month service authorization period. Plan renewal timelines carefully to avoid gaps in service.
Why Finding a Medicaid-Accepting Provider Can Still Be Hard
Coverage on paper is not the same as an open appointment slot. Reimbursement rates, provider supply and caseload capacity all affect how many practices can afford to take Medicaid families, and those rates are published separately from the manual in SCDHHS fee schedules rather than in the ASD manual itself. If you cannot find a Medicaid provider with open slots, contact your managed care organization or local Medicaid office to ask what options are available to you, and ask providers directly whether they are currently accepting new Medicaid members.
Finding an ABA Therapy Provider in South Carolina
Whether you are navigating the new school access law, preparing for the July Medicaid changes, or starting ABA therapy for the first time, finding the right provider is the most important first step.
ABA Navigator's directory includes ABA therapy providers across South Carolina, with clinics in Columbia, Charleston, Greenville, Myrtle Beach, and surrounding areas. You can search by insurance accepted, service setting (center-based, in-home, school-based), and location.
Find ABA therapy providers in South Carolina to search for clinics accepting new patients near you.
If you have questions about how to start the Medicaid authorization process, how to request services through your child's school under H.3974, or what to look for when choosing a provider, our South Carolina ABA therapy guide and our step-by-step guide to getting ABA therapy are good places to start.
Important Note
This article is for informational purposes only and is not legal, medical, educational or insurance advice. Medicaid manuals, service limits and school policies change, and how a law applies to your child depends on your specific circumstances. Confirm the current rules with SCDHHS, your school district, or a qualified professional before acting on anything here.
