When delivering applied behavior analysis (ABA) services as a healthcare provider, behavior analysts must be able to not only individualize the treatment approach, but also link goal development to medical necessity. Part of the challenge in goal writing is related to the likelihood that most providers did not receive specific training or education on how to write medically necessary goals. However, goal formulation is much more than addressing behaviors for increase or decrease within particular symptom domains. The connection between goal development and assessment results must be explicit. Additionally, so that the provider is clearly communicating to the payor about their intended treatment outcomes, goals must be based in conceptual systems and considerate of the dimension of technological. This is so that all stakeholders can have a good understanding of what clinical results may be achieved by the end of the client’s treatment period. This presentation will review the topics of medical necessity, meaningful goal development, and how that should be conveyed in a treatment plan.