Make a Referral to NCATP


Sticky Note with the word note in handwritingDue to the high volume of referrals, the NCATP intake process is taking up to three weeks for processing once all information is received. There may be an additional wait time once the referral packet is provided to the local consultant. Once the consultant receives the packet, appointments are being scheduled within 2-5 weeks depending on location.


Fee-based Assessment and Training Options

  • Assistive Technology Assessments or Alternative and Augmentative Communication (AAC) Assessments  are $575.00
    An assessment includes an in-depth analysis of devices to assist a person with a disability in achieving an identified task or goal.
  • Specialized Consultative Services (T2025) varies and is based on authorization from Managed Care Organization (MCO)
  • Individual Trainings are $125.00 per hour.
    Training includes technical skill building in the use of assistive technology devices, equipment or software packages.
  • Consultations are $125.00 per hour.
    NCATP staff provides assistive technology expertise to individuals or organizations for specific needs identified by the requesting party. 
  • Group Trainings are $500.00 (4 hours) $900.00 (8 hours)
    NCATP conducts specialized presentations, seminars or workshops regarding assistive technology to meet an organization's needs. 
  • Travel at $50.00 per hour
    NCATP charges travel time to conduct assessments, consultations, and training in the field.     

Making Referrals

All persons making referrals should complete the AT Referral for Services form. Please download this electronic form to complete and fax or mail to the Intake Coordinator’s information below along with the following information:

  • Authorization that commits to payment of the service fee (Example: Purchase Order, Agency Service Authorization Form, Letter from Authorizing Party)

  • Copies of current evaluations/medical information pertinent to this evaluation process. (Example: evaluations from school system, individual educational plans, evaluation’s conducted by private therapists, doctor’s records, etc.)

Additional forms are required for those parties seeking Alternative and Augmentative Communication (AAC) Evaluations. Please review and complete these forms in addition to the AT Referral for Service. Please note that any AAC assessment billed through Medicaid or insurance MUST have a prescription from primary care doctor.

  • Medical Billing Directions

  • Medical Billing Form

  • Financial Policy Acknowledgment

  • Financial Policy Acknowledgment (Spanish)

Mail or Fax Referral Information to:

Monique Cox, Intake Coordinator
North Carolina Assistive Technology Program
2801 Mail Service Center  
Raleigh, NC  27699-2801

Send a confidential fax to the attention of Monique Cox, Intake Coordinator: 919-715-1776

Please contact the Intake Coordinator if you have any additional questions or concerns.

919-855-3613 (Phone)
919-715-1776 (Confidential FAX)