New reporting from North Carolina Health News examines the rapid rise in autism therapy costs in the state and growing scrutiny over how Medicaid dollars are being spent.
State and federal Medicaid spending on applied behavior analysis (ABA) therapy in North Carolina has surged in recent years, reaching more than $505 million in 2025 and projected to exceed $1 billion by 2027. Lawmakers and regulators are now weighing changes to rein in costs, including tighter oversight, limits on telehealth, and new provider requirements.
The story cites a recent report from PESP, which found that private equity-backed providers have expanded significantly in the autism therapy industry. In North Carolina, 15 private equity-backed providers operate more than 130 facilities, making it one of the most saturated markets in the country.
Some of those providers were among the largest recipients of Medicaid payments for ABA therapy in the state, according to the reporting.
The article also includes comment from PESP healthcare researcher Ryan Leitner:
“Private equity firms are using autism therapy as a way to tap into Medicaid dollars. And what we’re seeing in audits across multiple states is that it’s coming with real problems. The same billing issues and oversight failures are showing up again and again, which raises serious concerns about how this care is being delivered.”
The reporting highlights how rising demand for autism services is intersecting with rapid cost growth and increased oversight, raising broader questions about how the industry is structured and regulated.
Read the full story:
https://www.northcarolinahealthnews.org/2026/04/27/autism-therapy-costs/
