PerformCare New Jersey: Autism Services Through the Children's System of Care

What Is PerformCare New Jersey?

PerformCare New Jersey is the single point of entry for the Children's System of Care (CSOC), a statewide network that coordinates services for children and youth with emotional, behavioral, intellectual, and developmental challenges. Managed by the New Jersey Department of Children and Families (DCF), PerformCare acts as a central hub - families call one number to get connected to mental health, substance use, and autism services, including Applied Behavior Analysis (ABA) therapy.

For families seeking autism services, PerformCare is often the first step. The system is designed to be family-driven and youth-guided, meaning parents and caregivers are active partners in planning care. Whether your child has a recent autism diagnosis or you're looking for more support, PerformCare can help you access Medicaid-funded services, private insurance options, and community resources.

🔗 Related reading: Autism IEPs & School Services in California Guide · Find ABA Near Me

Understanding the Children's System of Care (CSOC)

How CSOC Supports Children with Autism

The Children's System of Care (CSOC) is New Jersey's comprehensive approach to serving children and youth up to age 21 with complex needs. It brings together multiple state agencies - including DCF, the Division of Children's System of Care (DCSOC), and regional care management organizations (CMOs) - to ensure families don't have to navigate fragmented systems alone.

For autism, CSOC covers a range of services under its Intellectual/Developmental Disabilities (IDD) pathway. Most notably, ABA therapy is available for children with autism when it is medically necessary. Other covered services include speech therapy, occupational therapy, social skills groups, respite care, and case management.

Regional Care Management Organizations (CMOs)

After your initial call to PerformCare, a regional Care Management Organization (CMO) takes over coordination. New Jersey is divided into regional CMOs (e.g., Rutgers University Behavioral Health Care in the north, CPC Behavioral Healthcare in central/south) which assign a care coordinator. This single point of contact helps your family schedule assessments, find providers, and monitor progress.

Autism Services Available Through PerformCare

• Applied Behavior Analysis (ABA) therapy - 1:1 or group sessions, often in-home or clinic-based, led by a Board Certified Behavior Analyst (BCBA).
• Speech and Language Therapy - targeting communication skills and social pragmatics.
• Occupational Therapy - addressing sensory integration, fine motor, and daily living skills.
• Social Skills Training - group or individual coaching for peer interaction.
• Respite Care - temporary relief for caregivers, provided in-home or at community sites.
• Care Coordination - ongoing support from a care manager who helps families navigate the system.
• Early Intervention Services - for children under 3 through the NJ Early Intervention System (often coordinated with PerformCare after age 3).

Note: Services are tailored to each child's Individualized Service Plan (ISP) or treatment plan. Family participation is encouraged and often required for certain therapies like ABA.

🔗 Related reading: UnitedHealthcare ABA Therapy in Colorado: A Complete Guide · Local ABA Therapy

Eligibility: Who Qualifies for CSOC Autism Services?

Age and Diagnosis

Children and youth up to age 21 who reside in New Jersey and have a qualifying diagnosis - such as Autism Spectrum Disorder (ASD), any intellectual disability, or certain developmental delays - are eligible. A formal diagnosis from a licensed professional (pediatrician, psychiatrist, psychologist) is usually required. No specific severity level is needed, but services must be deemed medically necessary.

Insurance and Medicaid

NJ Medicaid (NJ FamilyCare) is the primary payer for CSOC services for eligible families. If your child has private insurance, PerformCare can help coordinate benefits - some services may be covered by your plan, while others may fall to Medicaid if you have both. Children with autism may qualify for Medicaid through the Katie Beckett waiver or other state programs regardless of family income, thanks to the Medicaid Autism Waiver (soon to be part of the 1915(i) state plan).

Even if you don't have insurance, CSOC assists with eligibility determination and application assistance. The system is designed not to deny care solely due to lack of coverage.

How to Get Started: The Step-by-Step Process

Step 1: Call PerformCare

The first move is to contact PerformCare's toll-free number: 1-877-652-7624. You'll speak with a care specialist who gathers basic information about your child, family situation, and the support you're seeking. This intake call is confidential and free. You can also request an online form, but many families find a phone call more direct.

Step 2: Eligibility Assessment

PerformCare will schedule an eligibility assessment conducted by a qualified clinician. This may be a face-to-face meeting (or telehealth) where they review your child's diagnosis, functional needs, and current services. The assessment determines whether your child qualifies for CSOC and which pathway (behavioral health or IDD) fits best.

Step 3: Assignment to a CMO and Care Coordinator

Once eligible, your family is assigned to a regional Care Management Organization. A dedicated care coordinator contacts you to discuss goals, complete a Child and Adolescent Needs and Strengths (CANS) assessment, and develop an Individualized Service Plan (ISP). This plan outlines the specific services and frequency needed.

Step 4: Provider Matching and Service Start

Your care coordinator helps you find providers that accept your insurance and have availability. For ABA therapy, this can involve contacting multiple agencies-waitlists are common. This is where our free service, ABA For My Child, comes in: we match families with vetted, BCBA-led ABA providers in New Jersey who accept PerformCare/CSOC referrals, saving you time and frustration.

What to Expect After Services Begin

Once services are arranged, your care coordinator remains involved for ongoing monitoring. They conduct at least quarterly reviews to ensure the plan is working. If your child's needs change, the ISP can be updated. You may also request a new provider or additional services at any time.

Remember: CSOC is a voluntary system. Families can choose to participate or decline services. You always have a say in your child's care.

Costs and Insurance: What Families Need to Know

NJ Medicaid (NJ FamilyCare)

Most children enrolled in NJ FamilyCare receive autism services through CSOC with no out-of-pocket costs - no copays, deductibles, or premiums for covered services. ABA therapy typically requires prior authorization but is covered when medically necessary.

Private Insurance

New Jersey has strong autism insurance mandates (the New Jersey Autism Insurance Law) that require large group health plans to cover ABA therapy and other evidence-based treatments up to age 21. If your private plan is governed by New Jersey law, PerformCare can help coordinate with your insurer. Some families find it easier to use private insurance directly for ABA, while using CSOC for case management or respite.

Medicaid Autism Waiver Changes

As of 2024, New Jersey is transitioning from the traditional Medicaid Autism Waiver to a 1915(i) State Plan Amendment. This means services will no longer be waiver-based but part of the regular Medicaid benefit - potentially reducing waitlists. PerformCare and CSOC are central to this transition.

Practical Tips and Common Mistakes to Avoid

Tips for a Smooth Process

• Gather documentation early: Have your child's autism diagnosis written report, insurance cards, and any prior evaluations ready when you call PerformCare.
• Be persistent: Wait times for assessment appointments can be weeks; follow up if you don't hear back within a week.
• Ask for a specific care coordinator name and contact: Keep notes of every call and the information you receive.
• Use a free matching service: Our service, ABA For My Child, helps you quickly find BCBA-led ABA providers that work with CSOC, cutting through waitlist delays.
• Understand your rights: You can request a different care coordinator or provider if you're not satisfied, and you can ask for a fair hearing if services are denied.

Common Mistakes

• Waiting too long to start: Even if you think your child's needs are mild, early intervention through CSOC can prevent later challenges.
• Not exploring all funding avenues: Some families assume they don't qualify for Medicaid and miss out on free ABA. Check income-based eligibility or the Katie Beckett pathway.
• Assuming PerformCare only handles mental health: Many autism families don't realize it also covers IDD services. Always ask about all available options.
• Going it alone: Dealing with multiple agencies can be overwhelming. Your care coordinator is there to help - use them. And if you need help finding the right ABA provider, let us match you for free.

Why Work with ABA For My Child?

We are a free, family-focused matching service - not a provider. Our mission is to connect families of children with autism in New Jersey to vetted, BCBA-led ABA therapy providers who accept CSOC funding (Medicaid, private insurance, or both). We understand the PerformCare system and can help you navigate it with confidence. There's no cost to you; we simply match you with providers who have openings and align with your family's needs.

If you've already contacted PerformCare and been assigned a care coordinator, we can still help identify ABA providers who are actively accepting new clients in your area. Just let us know your child's age, insurance, and desired location, and we'll share a list of options you can bring to your care coordinator for approval.