Make a Referral to NCATP

3 AAC device with multiple buttons

Fee-based Assessment and Training Options

  • Assistive Technology Assessments or Alternative and Augmentative Communication (AAC) Assessments  are $575.00
  • Specialized Consultative Services (T2025) varies and is based on authorization from Managed Care Organization (MCO)
  • Individual Trainings are $125.00 per hour.
  • Consultations are $125.00 per hour.
  • Group Trainings are $500.00 (4 hours) $900.00 (8 hours)
  • Travel at $50.00 per hour    

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:

Connie Gillespie, Intake Coordinator
North Carolina Assistive Technology Program
2801 Mail Service Center
805 Ruggles Dr.  
Raleigh, NC  27699-2801

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

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

919-855-3564 (Phone)
919-715-1776 (Confidential FAX)
atintake@dhhs.nc.gov