Indiana Behavioral Health & Substance Use Licensing Guide

Certifying agency

FSSA Division of Mental Health and Addiction (DMHA)Applications go through the DMHA Provider Portal

Addiction treatment

Regular or outpatient certification440 IAC 4.4; outpatient only for 10 or fewer direct service staff

Opioid treatment

New independent OTPs are barredHospitals, private mental health institutions and CMHCs may apply on a showing of need

Medicaid

IHCP enrollment rests on DMHA certificationResidential SUD billing also needs an ASAM 3.1 or 3.5 designation

Accreditation

Required for regular addiction certification, CMHCs, sub-acute facilities and private mental health institutionsCertification ends 90 days after accreditation expires

Licensing or accrediting a program here? Book a free consultation or call 561-396-0813.

Who certifies behavioral health providers in Indiana?

The Division of Mental Health and Addiction (DMHA), part of the Family and Social Services Administration (FSSA). DMHA certifies addiction service providers, community mental health centers (CMHCs), residential settings such as sub-acute stabilization facilities and opioid treatment programs, and it licenses private mental health institutions. Applications are filed in the DMHA Provider Portal.¹

Indiana Health Coverage Programs (IHCP), the Medicaid program, enrolls providers separately, and most behavioral health enrollments require current DMHA certification.²⁴ Residential treatment for youth is licensed by the Department of Child Services rather than through DMHA sub-acute certification.⁷

DMHA certification types

• Addiction services, regular: requires accreditation from a DMHA-approved body; the track for providers with 11 or more direct service staff.^{2, 3}
• Addiction services, outpatient: for 10 or fewer direct service staff, at least half licensed or holding an approved addiction credential and at least one with an addiction counseling credential. It covers outpatient, intensive outpatient, partial hospitalization and withdrawal management.^{2, 4}
• Temporary: a 12-month bridge, extendable once, for regular applicants not yet accredited.²
• Community mental health center: accredited for every service it delivers directly and assigned an exclusive geographic service area.⁶ Each location offering addiction services also needs regular addiction certification.⁵
• Sub-acute stabilization facility: 24-hour treatment for 4 to 15 residents, with crisis stays up to 45 days or rehabilitation stays up to a year. Only a CMHC, a managed care provider or a regular-certified addiction provider may apply.⁸
• Private mental health institution: a license for free-standing psychiatric inpatient facilities.⁹

Twenty-four-hour addiction care needs regular certification, or residential care provider certification under 440 IAC 6 plus outpatient certification.²

Law and rules

Addiction certification is governed by 440 IAC 4.4, last readopted in 2020.² CMHCs follow 440 IAC 4.1, sub-acute and other residential facilities 440 IAC 7.5, and private mental health institutions 440 IAC 1.5.^{6, 8, 9} Opioid treatment programs fall under IC 12-23-18 and 440 IAC 10, and recovery residence registration under IC 12-23-25.^{11, 12, 18} Policies must address patient rights under IC 12-27 and 42 CFR Part 2 confidentiality.³

How to apply for addiction services certification

1. Pick your trackCount direct service staff and choose regular or outpatient certification. You must be certified before services start.^{2, 4}
2. Line up accreditationRegular applicants need DMHA-approved accreditation, or an accreditation application the body has accepted. A temporary certificate also needs one staff member with an addiction counseling credential.^{2, 3}
3. Write your policiesAdmission, intake assessment, treatment planning, progress notes, discharge, consumer rights and confidentiality, typed into the portal as text.^{3, 4}
4. Gather documentsA current fire and safety inspection, a CEO-signed letter that a physician or clinical nurse specialist will supervise any withdrawal management, and for regular applicants the accreditation letter, full report and your response to its recommendations.^{3, 4}
5. Apply in the portalDMHA may require you to fix problems found by DMHA, the accreditor or a credentialing body before it certifies.^{1, 2}

Renewals and changes: request renewal 30 days before expiration. Regular certification expires 90 days after accreditation does; outpatient certification lasts two years. Report site, service and ownership changes in writing. Certification cannot move to another legal entity, and an outpatient provider reaching 11 direct service staff must start the regular process.²

Fees

The OTP fee divides DMHA's prior-year program cost by patients treated, excluding guest doses.^{11, 12} Registration fees took effect July 1, 2026.^{18, 19} Certification rules and pages show no fee.^{2, 5, 8}

How accreditation counts in Indiana

Built into certification: Indiana has no separate deeming program for these types. Regular addiction, CMHC and sub-acute certification and the private mental health institution license all require approved accreditation. You file the survey report, recommendations and your responses, and DMHA can require action on findings.^{2, 6, 8, 9} Certification follows the accreditation cycle: it expires 90 days after accreditation lapses, a longer lapse brings conditional status, and revocation ends it.^{2, 6} New sub-acute sites must join the accreditation within 12 months.⁷

Approved bodies: DMHA's list, revised June 2025, names The Joint Commission, CARF and COA, plus ACHC, NCQA and others for specific settings. COA surveys must use addiction standards for regular certification.¹⁰ The list notes CARF and COA lack CMS deeming authority, while the private institution rule defines an accreditor as one that has it, so psychiatric hospital projects should confirm their accreditor early.^{9, 10}

Fee breaks: none, since the certification rules set no fees.²

Medicaid: IHCP requires DMHA certification for CMHC, OTP and residential SUD enrollment, so accreditation is effectively a Medicaid prerequisite.²⁴

Opioid treatment: OTPs must be accredited by a body approved by DMHA and SAMHSA.¹² SAMHSA approves CARF International, Social Current (formerly COA), The Joint Commission, the National Commission on Correctional Health Care and the Washington State Department of Health.¹⁶

Getting accredited? See our CARF accreditation consultants and Joint Commission consultants, available nationwide.

Opioid treatment programs

• Moratorium: IC 12-23-18-5.5 bars new OTPs except applications pending before March 1, 2007 and programs run by a licensed hospital, a private mental health institution or a certified CMHC, on site or in a separate office meeting federal rules.¹¹ DMHA's OTP page still leads with the prohibition.¹³
• Expansion: the statute allowed up to five more such programs before June 30, 2018 and up to nine more from July 1, 2018, each only on a finding of need.¹¹
• Need test: 440 IAC 10-2-3 looks at distance (20 miles from an existing OTP unless need is significant), overdose, infection and crime indicators, opioid use disorder rates, community support letters, insurance acceptance and low-income caseload, plus INSPECT data. You can request a need decision before applying.¹²
• Per-site approval: each location needs its own approval and facility certification, and a move needs a new one. One extra non-dosing site is allowed in the same county.^{11, 12}
• Application: accreditation, SAMHSA certification, DEA and Indiana Board of Pharmacy registrations, the medical director's license and local and fire documents, plus 440 IAC 4.4 certification.¹² An OTP may not operate without Medicaid and Healthy Indiana Plan enrollment, or an ordering and referring enrollment with a CMHC agreement.¹¹
• Ongoing: recertify yearly (file 60 days ahead), submit a diversion control plan by February 28, report to the central registry monthly and expect an annual DMHA visit. An APRN or PA collaborating with an onsite physician may do admission assessments.^{11, 12}
• Federal steps: SAMHSA grants provisional certification for up to a year after state and DEA approval, and accreditation must follow within that year.¹⁵

Other approvals you may need

• Recovery residence designation: DMHA designates Levels II to IV under NARR standards; Level IV first needs addiction certification. DMHA reviews portal applications within 30 days and may visit unannounced.¹⁷
• Registration: since July 1, 2026 a home may use the name recovery residence only if registered with DMHA. Owners commit to ethical standards from NARR, the Indiana Affiliation of Recovery Residences or a similar group, and DMHA may contract with that affiliation to run the registry.^{18, 19}
• State-funded referrals: residences reimbursed by FSSA must hold DMHA certification.²⁰ Recovery Works, DMHA's justice-involved voucher program, pays only DMHA-certified Level II to IV residences, with billing tiers of $26, $30 or $34 by meal and medication policy.^{21, 22}
• Medicaid enrollment: CMHCs (type 11, specialty 111) need DMHA certification; OTPs (835) need DEA, SAMHSA and DMHA approval; residential SUD facilities (836) need sub-acute certification with an ASAM 3.1 or 3.5 designation, or DCS licensure plus regular certification with that designation. Out-of-state OTPs and CMHCs cannot enroll.²⁴
• ASAM designation and the 1115 waiver: DMHA designates after addiction and sub-acute certification.²³ IHCP covers 3.1 and 3.5 stays in facilities of any size, including institutions for mental disease, with prior authorization and a prescriber visit at least weekly.²⁵

Recent changes

• January 30, 2025: IHCP now requires CMHCs, OTPs, residential SUD facilities, CCBHCs and others to send updated DMHA certification before the one on file expires.²⁷
• March 27, 2025: DMHA filed a schedule of OTP civil penalties.¹²
• July 1, 2025: Senate Enrolled Act 473 let OTPs close Sundays and federal holidays, dropped hospital admitting privileges for medical directors, moved retesting after a positive test to monthly and barred DMHA admission and medication rules stricter than federal ones.^{11, 14}
• January 1, 2026: new Recovery Works residence billing tiers.²²
• July 1, 2026: House Enrolled Act 1296 created recovery residence registration.^{18, 19}
• Pending: LSA 25-797 would amend 440 IAC 10 to allow OTP medication units and mobile medication units; its second hearing was July 20, 2026.²⁶
• September 24, 2026: CMS extended the SUD and SMI parts of the 1115 waiver to June 30, 2027 during renewal talks.²⁸

Confirm these with DMHA

• Whether any fee applies to your certification.
• This year's OTP per-patient fee.
• For OTPs: how many post-2018 slots remain and whether your site qualifies.
• The final medication unit rule and its effective date.
• Registration rules under IC 12-23-25 and how they fit with designation.
• That your accreditor covers every service you want certified.
• Current ASAM designation steps and the 1115 renewal outcome.

Sources

1. Indiana FSSA DMHA, Quality assurance and quality improvement. in.gov
2. Indiana Administrative Code, 440 IAC 4.4, Addiction treatment services provider certification. iar.iga.in.gov
3. Indiana FSSA DMHA, Addiction services regular certification. in.gov
4. Indiana FSSA DMHA, Addiction services outpatient certification. in.gov
5. Indiana FSSA DMHA, Community mental health center certification. in.gov
6. Indiana Administrative Code, 440 IAC 4.1, CMHC certification. iar.iga.in.gov
7. Indiana FSSA DMHA, Sub-acute stabilization facility certification. in.gov
8. Indiana Administrative Code, 440 IAC 7.5, Residential living facilities. iar.iga.in.gov
9. Indiana Administrative Code, 440 IAC 1.5, Private mental health institutions. iar.iga.in.gov
10. Indiana FSSA DMHA, Approved accreditation (June 2025). in.gov
11. Indiana Code, IC 12-23-18, Opioid treatment programs (2026). iga.in.gov
12. Indiana Administrative Code, 440 IAC 10, Opioid treatment facilities and programs. iar.iga.in.gov
13. Indiana FSSA DMHA, Opioid treatment program. in.gov
14. Indiana General Assembly, Senate Bill 473 (2025), Public Law 143. iga.in.gov
15. SAMHSA, Become an opioid treatment program. samhsa.gov
16. SAMHSA, Approved accreditation bodies. samhsa.gov
17. Indiana FSSA DMHA, Recovery residence designation and registration. in.gov
18. Indiana Code, IC 12-23-25, Registration of recovery residences (2026). iga.in.gov
19. Indiana General Assembly, House Bill 1296 (2026), Public Law 32. iga.in.gov
20. Indiana Code, IC 12-21-5-1.5, DMHA duties (2026). iga.in.gov
21. Indiana FSSA DMHA, Recovery Works policies and procedures manual (September 2026). in.gov
22. Indiana FSSA DMHA, Recovery Works Memo 020 (February 2026). in.gov
23. Indiana FSSA DMHA, ASAM designation. in.gov
24. Indiana Health Coverage Programs, Provider enrollment module (September 2026). in.gov
25. Indiana Health Coverage Programs, Behavioral health services module (October 2026). in.gov
26. Indiana Register, LSA 25-797, Opioid treatment programs, second comment notice (June 2026). iar.iga.in.gov
27. Indiana Health Coverage Programs, Bulletin BT202516 (January 30, 2025). in.gov
28. CMS, Healthy Indiana Plan temporary extension approval (September 24, 2026). medicaid.gov

This guide summarizes Indiana statutes, rules and FSSA, DMHA and IHCP publications as of the date above. It is general information, not legal advice. Requirements change; confirm with DMHA before you apply.