BT vs RBT: what a behavior technician needs in Washington

Only in some situations. See the detail below.

As of 2026-10-21, RCW 18.380 requires state certification issued by the secretary (or a license) to practice ABA, unless a statutory exemption applies. Technicians use the state Certified Behavior Technician (CBT) credential: a paraprofessional who implements a plan under close, ongoing supervision of an LBA/LABA. State CBT certification is ordinarily required, but statutory exemptions and regulated trainee activity exist, and lacking an RBT credential alone does not prohibit practice by a state-certified CBT. CBT application: age 18+, high school diploma or equivalent, either a current credential from an accredited credentialing entity or completion of a training program of at least 40 hours (complete the training and submit the application within one year of starting the training program, per WAC 246-805-310(7)), and identification of the clinical supervisor as proof of ongoing supervision. A CBT may not start a client's program until an LBA/LABA, or another professional otherwise qualified under RCW 18.380.030(1) (as WAC 246-805-320 expressly provides), has evaluated the client and prepared the treatment plan. Statutory exemptions exist (e.g., school district employees and matriculated college or university students in training programs, each with conditions). Medicaid enrollment may be under a group's core provider agreement (CPA); an individual CPA is not universally required, and the CBT credential is needed for billing.

• State CBT certification from DOH (application fee $95; renews every two years at $150)
• Written supervision agreement with clinical supervisor, signed by both parties and retained by both, in place before the CBT performs behavior-analytic tasks (WAC 246-805-330)
• Continuing competency: maintain a credentialing-entity certification, or get a competency evaluation within 90 days before renewal (WAC 246-805-410); a CBT attesting to not working at renewal must obtain the specified assessment within three months after obtaining CBT employment

As of 2026-10-21: per WAC 182-502-0002 and the HCA ABA billing guide (the July 1, 2025 edition was the original source; HCA's current listing now shows a January 2026 guide that supersedes it), DOH-credentialed Licensed Behavior Analysts (LBA), Licensed Assistant Behavior Analysts (LABA) and Certified Behavior Technicians (CBT) are eligible to provide Apple Health ABA. Lead behavior analysis therapists (LBAT) are generally LBAs or LABAs; WAC 182-531A-0800(10) separately lists LBA/LABA for LBAT servicing enrollment, so that qualification should not be read as unrestricted eligibility. The rule also has a route for certain DOH-licensed mental health professionals who have a signed ABA attestation (HCA 13-0008) re BCBA/BCaBA certification. LABA supervision may be provided by an LBA or a licensed psychologist (WAC 182-531A-0800(9)(a) and (11)). CBTs must be DOH-certified in good standing with no license restrictions. HCA requires individual servicing-provider enrollment, which may be under a group's core provider agreement (CPA); the rendering provider's NPI must appear on claims (see the HCA enrollment alert). Access follows a pathway starting with referral to a Center of Excellence for evaluation.

No.

The Medicaid credential is the state DOH Certified Behavior Technician (CBT), not the RBT. RBT is an optional qualifying route. Under WAC 246-805-300 an applicant may qualify with current certification/registration from an accredited credentialing entity (e.g., RBT) OR by completing a DOH-approved training program of at least 40 hours. The training route must satisfy WAC 246-805-310, including experiential learning and competency assessment, not merely attendance at a 40-hour course. Either way the person must hold the state CBT certification to enroll as a CBT.