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What happens after you call PerformCare, step by step

Step-by-step guide for Bergen County families calling PerformCare for ABA therapy for an autistic child, including NJ forms and next steps.

Published · Bergen County, New Jersey

A father and daughter walking hand in hand along a tree-lined street

Step 1: You call PerformCare

You dial PerformCare, which is New Jersey's single access point for the Children's System of Care for children age 3 through 20. You are calling because your child has an autism diagnosis and you are seeking Applied Behavior Analysis (ABA) therapy. The person who answers will ask for basic information: your child's name, date of birth, address in Bergen County, and the diagnosis. They will also ask for your insurance information. If you have NJ FamilyCare (the state Medicaid and CHIP program), you will say so. If you have a managed care plan such as Horizon NJ Health, Wellpoint, Aetna Better Health of NJ, or UnitedHealthcare Community Plan, you will give the member ID number. If your child is under age 3, PerformCare will tell you that you need the New Jersey Early Intervention System instead, and they can transfer you.

Step 2: You complete a screening over the phone

The screening is called the CANS (Child and Adolescent Needs and Strengths). PerformCare staff will walk you through it. They will ask about your child's behaviors, communication, daily living skills, and safety. Be honest about the level of support your child needs. The screener will assign a score that helps determine eligibility for ABA through NJ FamilyCare or the managed care plan. You do not need to prepare anything special, but having your child's diagnostic report and any recent school or therapy notes nearby is helpful. The call usually takes 30 to 60 minutes.

Step 3: PerformCare gives you a referral number

After the screening, you will receive a referral number. Write it down. This is the number you will give to any ABA provider you contact. It signals that PerformCare has opened a case for your child. At this point, PerformCare will also tell you if your child is eligible for ABA services under NJ FamilyCare or your private insurance. If the child is over 21, PerformCare will refer you to the Division of Developmental Disabilities (DDD) instead.

Step 4: You choose a provider from the list

PerformCare will give you the names of a few ABA providers in Bergen County. You can also search on your own. There are 108 ABA providers registered in the county on the federal NPPES registry. Not every town has a provider within its borders. Only 45 of the county's 70 municipalities have an ABA provider registered in the town itself. But every town has at least one provider within 7 miles. If you live in a town with no local provider, look in nearby towns with the most providers: Hackensack (12), Montvale (9), Fair Lawn (8), Englewood (6), Mahwah (5), or Teaneck (5). School districts such as Alpine, Bergenfield, Bogota, Carlstadt, Cliffside Park, Closter, Cresskill, Dumont, Edgewater, and Elmwood Park are included in this coverage area.

Step 5: You call providers and check availability

When you call a provider, have your PerformCare referral number ready. Ask three questions: (1) Do you accept my insurance (NJ FamilyCare or my specific managed care plan)? (2) Are you accepting new clients for ABA therapy? (3) Do you provide in-home, clinic-based, or school-based services? The provider will likely ask for a copy of your child's diagnostic report and the CANS score from PerformCare. Availability varies. The provider may or may not have an opening. Some may offer an intake appointment soon. Others may not. You can call multiple providers. There is no penalty for contacting several.

Step 6: The provider conducts a behavioral assessment

Once a provider agrees to work with your child, they will schedule a behavioral assessment. This is typically a 2 to 4 hour session where a Board Certified Behavior Analyst (BCBA) observes your child, interviews you, and reviews records. They will write a formal ABA treatment plan. That plan must be sent to PerformCare and your insurance company for approval. This is not immediate. The approval process depends on your specific plan and the provider's workload.

Step 7: Services begin, and you stay in touch with PerformCare

After approval, ABA therapy sessions can start. The provider will give you a schedule. You will also have regular meetings with the BCBA. PerformCare will continue to check in at intervals (typically every 30 to 90 days) to update the CANS score and ensure services are still appropriate. If anything changes with your child's condition or your insurance, you will need to notify PerformCare. If you have concerns about the provider, you can call PerformCare and ask for help. They are the ongoing point of contact for your child's care through age 20.

Important note: PerformCare does not guarantee a specific wait time, provider, or number of therapy hours. Each child's situation and each insurance plan is different. If you hit a roadblock, ask PerformCare for a case manager or for a referral to the appropriate managed care plan. For children under 3, the process goes through the New Jersey Early Intervention System, not PerformCare. For youth over 21, contact the Division of Developmental Disabilities.

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