Sunny Skies ABA accepts Vaya Health (Vaya Total Care) across western NC. ABA covered for children under 21 — verify benefits free in 24 hours.
Vaya Health is one of four NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan operators in North Carolina. Through its Vaya Total Care plan, launched in July 2024, Vaya serves Medicaid members across 32 counties in western and central NC — including the entire NC mountain region and surrounding foothills. For families in Buncombe County and the broader western NC region, Vaya is the primary Tailored Plan.
For families with children diagnosed with autism, Vaya covers Applied Behavior Analysis therapy under a benefit category called Research-Based Behavioral Health Treatment (RB-BHT). ABA falls under RB-BHT and is a covered service for Vaya members under 21 with a confirmed autism diagnosis. Coverage flows through the federal EPSDT benefit, which protects medically necessary services for Medicaid-enrolled children. There is no hard hour cap on ABA — coverage is driven by clinical recommendation and documented progress.
Sunny Skies ABA is in-network with Vaya Health and serves families in Buncombe County including Black Mountain. Our intake team is familiar with Vaya's authorization process for RB-BHT services and submits all paperwork on your behalf, working closely with each family's Vaya care coordinator.
Once medical necessity is documented and Vaya's RB-BHT authorization is approved, the following are typically covered:
Because Vaya is a Tailored Plan, your child may have additional benefits beyond ABA — including I/DD waiver services, behavioral health residential supports, or other RB-BHT interventions — that we coordinate alongside ABA when appropriate.
Your child must be enrolled with Vaya Health — either through Vaya Total Care (Tailored Plan), Vaya's Medicaid Direct services, or Vaya's state-funded services for non-Medicaid eligible members. Enrollment depends on home county. We confirm enrollment during free verification.
Vaya requires a current DSM-5 diagnosis of Autism Spectrum Disorder with ICD-10 code F84.0 from a licensed psychologist, psychiatrist, developmental pediatrician, neurologist, MD, or DO. We refer you to local diagnosticians if your child does not yet have a formal diagnosis.
Most Vaya pathways require a referral from your child's primary care provider before ABA begins. The referral is part of the authorization packet we submit on your behalf.
Vaya requires prior authorization for RB-BHT (which includes ABA) before services begin. We submit a complete clinical packet — diagnosis, assessments, BCBA-developed treatment plan, and authorization forms. Reauthorization is required approximately every six months.
Free, no-obligation verification in 24 hours.
Complete our online benefits verification form with a photo of your Vaya member card and your child's information. Call (919) 502-1112 or email info@sunnyskiesaba.com.
Within 24 hours our intake team confirms Vaya enrollment, your county's coverage status, and the documentation needed to start your child's RB-BHT authorization.
We email a written summary of your Vaya coverage and book a free consultation to discuss next steps and begin the BCBA assessment.
Medicaid managed care for members with significant BH or I/DD needs across 32 western and central NC counties.
For members not yet transitioned to the Tailored Plan but receiving Vaya-coordinated services.
For NC residents without Medicaid who still meet clinical eligibility for behavioral health services.
For members with additional I/DD waiver services we coordinate alongside ABA.
Vaya Total Care covers 32 counties across western and central NC. Within these counties, Sunny Skies ABA serves the following cities:
Vaya also covers Alleghany, Ashe, Avery, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, McDowell, Macon, Madison, Mitchell, Polk, Swain, Transylvania, Watauga, Wilkes, Yancey and additional western and central NC counties. If your home county is served by Vaya but not listed above, contact us to check service availability.
Western NC families need a provider who understands Tailored Plan complexity and the RB-BHT benefit structure. Here's what Sunny Skies delivers:
Free benefits verification in 24 hours. No commitment.
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