Determining Sustainable Caseload Sizes for BCBAs

What is an appropriate caseload size for a BCBA? This is a common question pondered in ABA forums–by both BCBAs who are trying to identify what’s “normal” or expected in this field, as well as leaders of ABA practices who are trying to establish sustainable caseload sizes for their analysts. Finding the right balance between quality care, staff satisfaction, and financial viability can be a challenge, and there is no one-size-fits-all answer.

So–what is a sustainable caseload for a BCBA? Let’s explore!

Rethink BCBA Caseloads: It’s Not Just About the Number of Clients

When people talk about BCBA caseloads, they often focus on how many clients the clinician oversees. But caseload size isn’t just about the headcount–it’s about the amount of time and effort required to support those clients' individualized needs.

Consider this example:

BCBA A has 8 clients who each receive 40 hours per week.
BCBA B has 12 clients who each receive 20 hours per week.

At first glance, it appears that BCBA B has a larger caseload due to the higher number of clients. There is no denying that additional clients come with additional responsibilities, but in this example, BCBA A oversees 320 weekly hours compared to BCBA B’s 240-hour caseload–an extra 80 hours per week makes a huge difference. This underscores an important consideration: caseload size should be measured by the total caseload hours, not solely the number of clients. Let’s investigate this further.

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Shift the Focus from Clients to Total Caseload Hours

Rather than focusing solely on the number of clients, consider how many total weekly therapy hours the BCBA oversees. In other words, what is the total number of direct therapy hours they are responsible for overseeing each week? Total caseload hours do not refer to the hours the BCBA works, but rather the number of hours under them (i.e., the hours their RBTs work).

Example: A BCBA with six clients who each receive 30 hours per week would carry a 180-hour caseload.

While the right caseload size depends on multiple factors–which we’ll explore in the next section–most BCBAs working a standard 40-hour workweek will fall within the 130-200 hour caseload range.

Let’s break that down with an example: What would a 200-hour weekly caseload size look like? Keep in mind that a BCBA should provide 10-20% case oversight, in addition to ongoing caregiver training.

If a BCBA has 200 weekly hours under them, doing the bare minimum of 10% case oversight would put them at 20 billable hours per week. It’s important to emphasize that 10% is the minimum, not necessarily the goal. Many clients and staff need additional support. If that BCBA has 10 clients and provides caregiver training for 1 hour per week for each client, that’s another 10 hours. That now puts them at 30 billable hours per week. This doesn’t factor in assessment/treatment planning or additional protocol modification.

To further visualize how total caseload hours translate into billable responsibilities, consider the chart below. It outlines the number of protocol modification hours (97155) required per week, assuming the BCBA provides this service for 10-20% of the total weekly hours.

Note: This does not include caregiver training (97156)—To calculate the total billable hours with caregiver training, add an additional 0.5-1 hour per client per week.

Weekly Caseload Size	Weekly Billable Protocol Modification Hours Required (10-20%)
125	12.5-25
150	15-30
175	17.5-35
200	20-40
225	22.5-45
250	25-50
275	27.5-55
300	30-60

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Additional Factors that Influence Caseload Size

There are endless potential factors that can influence what constitutes a sustainable caseload size within and across ABA companies.

Some things to consider include:

Experience–Newly certified BCBAs should be assigned a caseload on the lower end, while systematically increasing caseload size as they demonstrate confidence and competency.
Support of a Mid-Level Supervisor–A BCBA’s caseload size may increase when they have the support of a mid-level supervisor (e.g., BCaBA, Case Manager, Senior Therapist).
Individualized Client Need–Clients with more significant needs, such as higher intensity interfering behaviors, will require more attention from the BCBA, impacting the number of cases the BCBA can take on. The acquisition rate of the clients can also influence how much time the analyst needs to dedicate to each client.
RBT Experience–The experience level of the RBTs on the BCBA’s caseload is another big factor. RBTs with minimal experience will likely need more supervision, taking up a greater portion of the BCBA’s time.
Location of Services–BCBAs working in a clinic or school setting can typically take on a larger caseload compared to in-home and community-based analysts.
Administrative Workload–The amount of non-clinical, non-billable responsibilities a BCBA has (e.g., scheduling, attending meetings, fieldwork supervision) will play a significant role in the number of caseload hours they can take on.
Administrative Support–Backend support for administrative responsibilities like scheduling may allow BCBAs to take on a larger caseload than they would otherwise be able to manage.

Consequences of a Large BCBA Caseload

Overextending BCBAs with an unmanageable caseload can lead to a range of negative repercussions, including:

Compromised Quality of Care–When behavior analysts are stretched too thin, quality of care is likely to suffer.
Increased Risk of Missed Deadlines & Errors–A larger caseload increases the likelihood that clinicians will struggle to meet deadlines for administrative and clinical responsibilities. Treatment plans and other documentation may also be error-ridden and/or submitted late.
BCBA burnout–Chronic, unmanaged workplace stress can result in burnout, which has significant implications for clinicians, clients, and the organization as a whole. Overextending BCBAs with heavy caseloads is a recipe for burnout.
Ethical violations–BCBAs are bound by the Ethics Code for Behavior Analysts. Per Section 3.03, analysts must only accept clients whom they have sufficient time and resources to effectively support. Taking on an unmanageable caseload may constitute an ethical violation.
Staff turnover–Staff retention is at risk when assigning unsustainable caseloads. When BCBA demand is at an all-time high with a significant undersupply of clinicians, ABA practices must put forth efforts to avoid BCBA turnover.

What Size Caseload Should a BCBA Have?

BCBAs should have a caseload size in the range of 130-250 weekly hours. The exact number of weekly caseload hours will vary depending on several factors, including whether or not they have the support of a BCaBA. While the number of clients is one factor in caseload size, I encourage BCBAs and ABA practices alike to take a more holistic approach in considering relevant factors, including the total caseload hours.

Take time to consider all factors when establishing BCBA caseload sizes to promote positive client outcomes, prevent staff burnout, and ensure long-term organizational success. A well-balanced caseload for BCBAs will set the behavior analyst and their clients up for long-term success.