NORTH CAROLINA · BEHAVIORAL HEALTH
Selling a behavioral health practice in North Carolina
In North Carolina, a mental health or substance use facility licensed under Chapter 122C changes hands only when DHSR approves the license change. The request must be filed at least 30 days ahead, and until approval the seller stays responsible for the facility and the people it serves. Behavior analysts are licensed by the North Carolina Psychology Board, and NC Medicaid covers research-based behavioral treatment such as ABA for members under 21.
By Akim Guennani, Founder · Updated October 2026
North Carolina behavioral health at a glance
| Mental health and SUD facilities | Licensed under G.S. Chapter 122C by DHSR Mental Health Licensure and Certification |
|---|---|
| Change of ownership | Change application at least 30 days before; seller responsible until approved |
| Behavior analysts | Licensed by the NC Psychology Board under the Behavior Analysis Practice Act |
| Medicaid ABA | Research-based behavioral health treatment for members under 21 (EPSDT) |
Licensed facilities: approval before responsibility moves
Mental health, developmental disability, and substance use facilities licensed under Chapter 122C go through DHSR's Mental Health Licensure and Certification Section for a change of ownership. Change requests must be submitted at least 30 days before the anticipated change, with a fee and documentation of the new owner, entity type, and ownership structure.
DHSR treats the license change as separate from the business transaction. Until the Licensure and Training Team officially grants the transfer to the new provider, the original licensee remains responsible for the facility and the people served. Sellers should plan for that period in the purchase agreement, including who staffs and insures the facility until approval.
ABA therapy: licensure and Medicaid
North Carolina added the Behavior Analysis Practice Act as Article 43 of Chapter 90, placing behavior analysis under the North Carolina Psychology Board. Behavior analysts and assistant behavior analysts must be licensed before practicing in the state, and buyers will check every clinician's license.
NC Medicaid covers research-based intensive behavioral health treatment for autism, including ABA, for members under 21 through EPSDT. Buyers look at Medicaid versus commercial revenue, authorization trends by plan, and analyst tenure and caseload.
Outpatient mental health
Therapy and psychiatry practices are valued on clinicians and payer contracts: credentialing with each commercial and NC Medicaid plan, how much volume you personally deliver, and clinician tenure. If your practice operates a licensed 122C facility, the change process above applies.
What North Carolina buyers underwrite
These items move price the most in North Carolina.
- Licensing path
- 122C license change timing and who is responsible until approval.
- Clinician licensure
- North Carolina licenses for analysts, therapists, and prescribers, plus tenure.
- Payer contracts
- NC Medicaid plans and commercial contracts in the practice's name.
- Documentation
- Authorizations and treatment records that support billing.
Sources
Rules change. This page summarizes public sources as of the review date and is educational, not legal, tax, or regulatory advice. Confirm licensing and change of ownership steps with counsel and the relevant state agency before signing.
- 1. Instructions for mental health license change applications (NC DHHS Division of Health Service Regulation)
- 2. G.S. Chapter 90, Article 43, Behavior Analysis Practice Act (North Carolina General Assembly)
- 3. Research-based behavioral health treatment for autism spectrum disorder, state plan amendment (Centers for Medicare & Medicaid Services)
Reviewed October 2026
Questions North Carolina owners ask
Straight answers, before you commit to anything.
When does a buyer become responsible for my licensed North Carolina facility?+
Only once DHSR officially grants the license transfer. Until then, the original licensee remains responsible for the facility and the people served.
How far ahead must I file a 122C change of ownership?+
At least 30 days before the anticipated change, with the required fee and ownership documentation.
Do behavior analysts need a North Carolina license?+
Yes. Under the Behavior Analysis Practice Act, behavior analysts and assistant behavior analysts must be licensed by the North Carolina Psychology Board.
Does NC Medicaid cover ABA?+
Yes. NC Medicaid covers research-based behavioral health treatment for autism, including ABA, for members under 21 through EPSDT.
Related guides
Behavioral health in other states
- Selling a behavioral health practice in Texas
- Selling a behavioral health practice in Florida
- Selling a behavioral health practice in California
- Selling a behavioral health practice in New York
- Selling a behavioral health practice in Pennsylvania
- Selling a behavioral health practice in New Jersey
- Selling a behavioral health practice in Ohio
- Selling a behavioral health practice in Illinois
- Selling a behavioral health practice in Georgia
- Selling a behavioral health practice in Michigan
- Selling a behavioral health practice in Massachusetts
- Selling a behavioral health practice in Arizona
- Selling a behavioral health practice in Virginia
- Selling a behavioral health practice in Maryland
- Selling a behavioral health practice in Tennessee
- Selling a behavioral health practice in Colorado
- Selling a behavioral health practice in Washington
- All states →
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