The contractor vs. employee question sounds simple — until you're operating in ABA or behavioral health. Once clinical supervision requirements, Medicaid contracts, and state licensing laws enter the picture, generic HR guidance stops being enough. Getting classification wrong in this field doesn't just create a tax headache. It can affect audits, credentialing, licensure, and more. Here's what agencies consistently get wrong — and what actually matters.

There’s a version of starting an ABA practice that a lot of us picture at the beginning. It looks like: Supporting clients Providing high-quality clinical care Building meaningful relationships Creating services you believe in And yes, that is part of it. But it’s not most of it. The Reality No One Talks About Starting an ABA agency often looks more like: Spending hours troubleshooting billing issues and denied claims Constantly tracking compliance requirements across multip