While the autism treatment provider market is not the most active Behavioral Health Care (BHC) specialty, it has seen notable fluctuations in M&A activity over the past five years, driven largely by private equity investments and evolving industry dynamics.
According to data captured in the LevinPro HC database, in 2020, there were 15 autism transactions reported, representing 20% of the BHC deals of the year. This climbed to 20 deals in 2021 (15% of BHC deals); however, deal totals decreased back to 15 in 2022 (13% of BHC deals). With the lowest autism deal totals for the last five years, there were only 11 reported in 2023 (15% of BHC deals). In 2024, there were 13 deals announced (19% of BHC deals) and there have been four transactions reported in 2025 (25% of BHC deals), so far.
Out of the 78 autism deals announced since January 1, 2020, 59 of the transactions were completed by a private equity group, including portfolio companies, representing 76% of the autism deals. Some of the active private equity companies include Center for Social Dynamics, Inc., a portfolio company of NMS Capital and Proud Moments ABA, which is part of Audax Private Equity’s umbrella.
The second most active buyer type is independently owned behavioral health care centers with 12 transactions since 2020. Active companies include Lighthouse Autism Center, LLC and Ontario Teachers Pension Plan Board. No other buyer types have a significant presence in the autism market.
In 2024, there were no buyers that completed more than one transaction, showing both the fragmentation of the market and room for new investors and players to move into the space. However, in 2025, Already Autism Health has completed two transactions. It acquired C.A.B.S., Autism and Behavior Specialists and Commonwealth ABA.
Founded in 2008, C.A.B.S., Autism and Behavior Specialists provides evidence-based behavioral therapy for individuals with autism spectrum disorder. The company has locations in Illinois and Georgia. Based in Florence, Kentucky, Commonwealth ABA is focused on delivering autism services to children and adolescents with autism spectrum disorder. These two transactions follow Already Autism Health’s acquisition by the private equity group Triton Pacific Healthcare Partners in January 2025. Since Already Autism Health was purchased less than a month ago and has already announced two transactions, it is safe to assume that Triton Pacific Healthcare Partners has big plans to expand the company’s reach and may announce more acquisitions in the near future.
Additionally, since the beginning of 2020, the most active buyer has been The Stepping Stones Group, a portfolio company of private equity group Five Arrows Capital Partners, which has completed seven acquisitions.
Based in Lafayette, Colorado, The Stepping Stones Group provides therapy and behavioral health services to children in the K-12 educational setting. Stepping Stones serves more than 1,000 clients and 300,000 children annually across 42 states. Stepping Stones was founded in 2014.
Over the last five years, the company has purchased six autism treatment centers in California and one in Massachusetts.
In a May 5, 2021 press release, Michael Langer, Partner at Five Arrows Capital, said, “Five Arrows Capital Partners continues to support Stepping Stones’ management team acquisitive growth strategy as they expand the company’s national geographic footprint and service offerings to deliver critical developmental services to children and adolescents.”
Another active buyer in the autism space is Acorn Health, backed by private equity firm MBF Healthcare Partners, LP, which has announced five deals since 2020. Its most recent transaction was the acquisition of seven ABA centers in Florida and Virginia.
Acorn Health, formed in October 2018, manages a network of behavioral health companies that offer ABA. It has locations in Michigan, Florida, Illinois and Virginia. The addition of the seven centers takes Acorn’s presence to 14 centers in Florida and 13 centers in Virginia. The centers were acquired through Breakthrough Behavior Florida. Terms were not disclosed.
Purchase prices are not commonly disclosed in the autism M&A market, mostly because a large portion of the buyers are private equity groups. However, since the start of 2020, there have been five transactions with disclosed purchase prices in the autism space.
The largest deal since 2020, in terms of price, was Charlesbank Capital Partners’ (CPC) acquisition of Action Behavior Centers from NexPhase Capital for $840 million.
Action Behavior Centers provides applied behavior analysis (ABA) therapy services for children on the autism spectrum through its numerous clinics across Texas. The company has more than $60 million in projected annual adjusted earnings.
CPC is a middle-market private investment firm managing more than $7 billion of capital. Charlesbank focuses on management-led buyouts and growth capital financings and engages in opportunistic credit and technology investments.
According to the August 17, 2022, press release, this transaction represents CPC’s first investment in the behavioral health care market. Typically, it is more active in the dental market through its portfolio company MB2 Dental Solutions.
In 2024, the only transaction to have a disclosed price was Tenex Capital Management’s acquisition of Behavioral Innovations for $300 million. The seller was Chicago based private equity group Shore Capital Partners. According to a report by Mergermarkets, the acquisition commands a valuation in the high teens. Tenex Capital Management is a private equity firm that invests in middle-market companies.
Behavioral Innovations provides center-based and in-home ABA therapy, speech therapy and occupational therapy services to children ages birth through 18 with autism spectrum disorder and other related developmental disabilities. The company has 80 locations in three states: Colorado, Oklahoma and Texas. Almost 80% (63) of its locations are in Texas.
Industry experts point to several key trends shaping the future of the autism therapy market, including growing private equity interest, potential shifts in Medicaid funding and insurance reimbursement policies, evolving state regulations affecting provider profitability, and increasing competition among investors for market consolidation.
The Levin team was able to speak with Randy Decko, Senior Director at Agenda Health, who provided commentary on the ABA market. “We anticipate strong ABA M&A activity these next few years, barring any major macro-level changes that would reverse current M&A tailwinds. We’ve already closed four ABA transactions in 2025, with an even stronger pipeline behind it,” he said.
A December 2024 Behavioral Health Business article highlights expectations for greater engagement and accountability from families and payers. It also notes a push toward multidisciplinary care models, a demand for clearer career pathways for employees, and the increasing role of technology in improving care quality and operational efficiency.
Similarly, a March 2024 National Law Review article discusses heightened regulatory scrutiny as the sector grows, institutional investment expands, and commercial and government funding increases.
Over the past five years, deal activity in the autism therapy market has fluctuated, reflecting broader behavioral health investment trends. While transaction volumes have varied, private equity firms remain the primary drivers of acquisitions and consolidation. Despite challenges such as regulatory oversight, changes in Medicaid funding, and shifting reimbursement policies, investor interest remains strong. With continued demand for autism services and a competitive investment landscape, M&A activity in the sector is expected to remain active in 2025.
