Oklahoma Behavioral Health & Substance Use Licensing Guide

Certifying agency

Department of Mental Health and Substance Abuse Services (ODMHSAS)Its Board certifies programs under Title 43A

Substance use certification

Alcohol and drug treatment programOAC 450:18; required whatever the funding source

Application fee

$1,000 per certification period$100 for community residential mental health programs

Opioid treatment

OTP certification under OAC 450:70Plus DEA registration, SAMHSA certification and accreditation

Accreditation

CARF, Joint Commission or COA can satisfy some state standardsSupports three-year Special Distinction and is required for SoonerCare residential SUD

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

Who certifies behavioral health programs in Oklahoma?

ODMHSAS. Title 43A requires ODMHSAS certification before a program offers alcohol and drug treatment, whatever the funding source, so certification has to come before billing. ODMHSAS certifies organizations, not individual clinicians, for each program type it oversees.^{1, 2} The Board of Mental Health and Substance Abuse Services sets the standards and can certify a facility for up to 36 months. Running an uncertified substance abuse treatment program is a misdemeanor.⁴

The Oklahoma Health Care Authority (OHCA) runs SoonerCare, the state Medicaid program, and contracts with each behavioral health agency site.¹¹ Since April 1, 2024, SoonerCare children, parents, pregnant women and adults aged 19 to 64 have been enrolled in SoonerSelect managed care plans, which cover behavioral health along with physical health.^{12, 13} The State Department of Health licenses residential facilities and nursing homes, and youth residential SUD programs also need a residential child care facility license from the Department of Human Services.^{1, 11}

Who is exempt: licensed professionals in their own private practice, licensed hospitals, state-operated programs, Alcoholics Anonymous and Salvation Army programs, faith-based nonresidential recovery programs, residential recovery programs with fewer than 12 residents, recovery programs not collocated with certified treatment, and health centers except for ASAM levels 2.1 to 4.⁴

ODMHSAS certification types

ODMHSAS certifies these program types, each under its own chapter of OAC Title 450:^{1, 7}

• Alcohol and drug treatment, outpatient or residential (450:18), and comprehensive community addiction recovery centers (450:24).
• Opioid treatment programs (450:70).
• Community mental health centers (450:17), which may add Certified Community Behavioral Health Clinic (CCBHC) certification.
• Community-based structured crisis centers (450:23), limited to mental health centers, addiction recovery centers and ODMHSAS-run facilities.
• Specialty programs: assertive community treatment (450:55), eating disorder treatment (450:60) and gambling treatment (450:65).
• Community residential mental health programs that contract with ODMHSAS (450:16).
• Outpatient mental health (450:27), which is optional: national accreditation is an alternative route to SoonerCare and ODMHSAS payment.

Substance use levels of care under 450:18 are outpatient (ASAM 1); halfway houses (ASAM 3.1) for adults, adolescents, and parents with children or pregnant women; residential treatment for adults with co-occurring disorders (ASAM 3.3); residential treatment (ASAM 3.5) for adults, adolescents, and parents with children or pregnant women, including intensive versions; and medically supervised withdrawal management (ASAM 3.7).⁸

Mental health centers are limited to one per service area, except that Oklahoma and Tulsa counties are joint service areas.¹⁰ ODMHSAS says every service area already has one.¹

Law and rules

43A O.S. 3-415 requires certification of alcohol and drug treatment, recovery and rehabilitation services and lists the exemptions.⁴ 43A O.S. 3-601 governs opioid treatment programs, and 43A O.S. 3-417.1 governs where halfway houses and transitional living centers may locate.^{6, 5} OAC 450:1, Subchapter 9 sets the application process, certification statuses and fees for every program chapter, along with the core organizational, core operational and quality clinical standards. Each standard is rated as critical or necessary.⁷ The substance use standards are in OAC 450:18 and the opioid treatment standards in OAC 450:70.^{8, 9}

How to get ODMHSAS certification

1. Request the applicationAsk Provider Certification (ProviderCert@odmhsas.org) for the certification application packet, which it sends electronically.^{1, 2}
2. Submit the packet and feeInclude proof that the business is registered with the Secretary of State, every service site, and your key staff. The clinical director must be licensed in the area you will treat (or show training in it if you offer both SUD and mental health care) and work at least 10 hours a week. Missing materials not supplied within 60 days mean denial.⁷
3. Clear the siteProvide a fire inspection from the local fire department or State Fire Marshal with all items cleared; private or landlord inspections are not accepted. Alcohol and drug programs also need a zoning letter from the local zoning authority.² A new halfway house or transitional living center cannot open within 1,000 feet of a school.⁵
4. Policy review and site visitODMHSAS reviews your policies up to three times, then visits the site.² After the report, you have 10 working days to fix deficiencies in necessary standards and 5 working days to file a correction plan for critical ones.⁷
5. Permit for Temporary Operations (PTO)ODMHSAS then grants a six-month PTO so you can start services. It cannot be renewed, though ODMHSAS may extend it up to 90 days. Notify ODMHSAS within 14 calendar days of starting clinical services.⁷ ODMHSAS says you cannot bill Medicaid while on a PTO.²
6. Clinical review and certificationBefore the PTO ends, reviewers check clinical and staff records. Certification for one or two years needs 90% of critical standards at the first review (100% after corrections) and 75% of necessary standards. With fewer than five active cases, the maximum is one year.^{7, 3}

Renewals and changes: ODMHSAS usually sends an expiration notice about 60 days ahead. You then have 60 days to return the renewal application, fee and materials, and you can attest that unchanged policies are still current.^{3, 7} A program in good standing can add sites, or programs at the same or a lower level of care, without a new PTO. A change in majority ownership or board can lead to a one-year probationary certification. Programs found operating before getting a PTO must obtain one and are limited to one-year certifications for their first two years.⁷

Certification fees

The fee is payable to ODMHSAS with the application.⁷ The statute lets the Department set certification and renewal fees.⁴ The rules list no separate per-site, per-bed or OTP fee; confirm the current amount with Provider Certification before you pay.

How accreditation counts in Oklahoma

Standards: the statute requires certified alcohol and drug services to follow the standards of The Joint Commission, CARF, COA or other standards the Board approves.⁴

Partial deemed status: ODMHSAS may accept Joint Commission, CARF or COA accreditation as meeting certain specific state standards. You must apply and send proof of the accredited programs, every survey report, any later accreditor actions, plans of correction and the accreditation dates. ODMHSAS can still check those standards itself.⁷ A single letter from the accreditor is not enough.³

Survey waivers: the rules do not waive ODMHSAS site reviews for accredited programs.⁷ Accreditation instead counts toward Certification with Special Distinction, which lasts up to three years. It is open at renewal to programs certified for at least a year beyond the PTO that score 90% on critical and 85% on necessary standards. If accreditation lapses, the status drops to Certification with Distinction.^{7, 3}

Fee breaks: there is no accreditation discount. Fee refunds depend on compliance scores, not accreditation.⁷

Medicaid: an outpatient behavioral health agency can enroll with SoonerCare if it holds Joint Commission, CARF, COA, ACHC or AOA accreditation and is incorporated with a board of directors, or if it holds ODMHSAS certification. Substance use agencies also need 450:18 certification, and day treatment, partial hospitalization and intensive outpatient services need CARF, Joint Commission, ACHC or COA accreditation.¹¹ Residential SUD providers need ODMHSAS residential certification plus accreditation from The Joint Commission, CARF, COA or another CMS-approved body.^{11, 1}

Opioid treatment: federal rules require accreditation. SAMHSA's approved bodies are 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

• State and federal approval: an OTP needs Board certification and DEA registration and must follow the federal OTP rules in 42 CFR Part 8, including directly observed drug testing.⁶
• Need determination: ODMHSAS alone decides whether a new program is needed. Applicants submit waiting lists, opioid-related emergency room and arrest data, letters of support from local officials and nearby residents, marketing plans, proof of funding, compliance history and a signed commitment from the program sponsor and medical director.⁹
• Medication units: a stand-alone unit needs written approval from SAMHSA and ODMHSAS, ODMHSAS certification, Oklahoma Bureau of Narcotics (OBNDD) approval and national accreditation. A mobile unit must be tied to a physical OTP site.⁹
• Central registry: report each admission, change in medical status and discharge to ODMHSAS within 24 hours.⁹
• Closing or moving: give at least 30 days' notice; a new location must be certified first.^{6, 9}
• Federal steps: SAMHSA grants provisional certification for up to one year only after state and DEA approval, and the program must be accredited within that year.¹⁵

Other approvals you may need

• Recovery residences: homes with fewer than 12 residents, or not collocated with certified treatment, are exempt from certification, and ODMHSAS must offer voluntary certification to the second group on request.⁴ In practice, ODMHSAS points operators to the Oklahoma Alliance for Recovery Residences (OKARR), the NARR affiliate, for certification, and the homes it funds hold OKARR levels.¹⁴
• SoonerCare enrollment: each site needs its own OHCA contract and site-specific accreditation or certification, and each rendering clinician needs an individual contract.¹¹
• SoonerSelect plans: OHCA urges providers to contract with all three plans: Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health.¹² Children in foster care, receiving adoption assistance or in the juvenile justice system are in the Children's Specialty Program run by Oklahoma Complete Health, and American Indian and Alaska Native members may opt in.¹³
• Youth residential: residential SUD treatment for anyone under 18 needs a DHS residential child care facility license, and on-site child care needs a DHS child care center license.¹¹

Recent changes

• Certificate of need repealed (May 6, 2024): HB 2330 repealed Oklahoma's certificate of need law for psychiatric and chemical dependency facilities.¹⁷
• September 1, 2025: ODMHSAS removed the certificate of need subchapters from 450:18 and 450:24, revised the certification status and renewal rules, and amended much of the OTP chapter, including dosing, take-home doses and medication units.^{7, 8, 9}
• January 1, 2026: under HB 2104 (2025), breaking the OTP statute or its rules is now a Class D1 felony.⁶
• SB 1572 (signed May 21, 2026): the State Commissioner of Health, working with ODMHSAS, must study a possible merger of the two agencies and report by March 1, 2027. The Health Commissioner may also lead ODMHSAS during the study. The agency keeps its name for now.¹⁸
• June 5, 2026: Governor Stitt named Josh Anderson interim ODMHSAS commissioner.¹⁹
• July 11, 2026: new CCBHC rule amendments in 450:17, and new admission and exclusion criteria in 450:23 for facility-based crisis stabilization and urgent recovery clinics, including for minors.¹⁰
• September 1, 2026: OHCA amended its residential SUD provider rule, 317:30-5-95.44.¹¹

Confirm these with ODMHSAS

• Whether a certificate of need still applies to new residential programs. ODMHSAS's certification page and OHCA's residential SUD rule still mention one, though the law and ODMHSAS's own rules no longer require it.
• Which standards your accreditation will satisfy; the rule says only certain specific standards.
• The current application fee and whether any other fees apply to your sites or services.
• The clinical record score you need on your first review, which ODMHSAS's FAQs state differently.
• For OTPs: whether ODMHSAS sees a need for a new program in your area.
• Whether ODMHSAS runs its own voluntary recovery residence certification, or relies on OKARR.
• The outcome of the SB 1572 merger study and any change to the agency's structure or name.

Sources

1. Oklahoma ODMHSAS, Provider certification. oklahoma.gov
2. Oklahoma ODMHSAS, New programs: overview of the certification process. oklahoma.gov
3. Oklahoma ODMHSAS, Renewing programs: overview of the certification process. oklahoma.gov
4. Oklahoma Statutes, 43A O.S. 3-415, Certified services for the alcohol- and drug-dependent. oscn.net
5. Oklahoma Statutes, 43A O.S. 3-417.1, Location of transitional living centers and halfway houses. oscn.net
6. Oklahoma Statutes, 43A O.S. 3-601, Opioid substitution treatment programs. oscn.net
7. Oklahoma Administrative Code, Title 450, Chapter 1, Subchapter 9, Certification and designation of facility services. rules.ok.gov
8. Oklahoma Administrative Code, Title 450, Chapter 18, Substance related and addictive disorder treatment services. rules.ok.gov
9. Oklahoma Administrative Code, Title 450, Chapter 70, Opioid treatment programs. rules.ok.gov
10. Oklahoma Administrative Code, Title 450, Chapters 17 and 23, Community mental health centers and community-based structured crisis centers. rules.ok.gov
11. Oklahoma Administrative Code, Title 317, Chapter 30, OHCA outpatient behavioral health and residential SUD provider rules (317:30-5-240 to 240.2 and 317:30-5-95.44). rules.ok.gov
12. Oklahoma Health Care Authority, What providers need to know before SoonerSelect go-live. oklahoma.gov
13. Oklahoma Health Care Authority, Learn about SoonerSelect. oklahoma.gov
14. Oklahoma ODMHSAS, Recovery-based housing. oklahoma.gov
15. SAMHSA, Become an opioid treatment program. samhsa.gov
16. SAMHSA, Approved accreditation bodies. samhsa.gov
17. Oklahoma Legislature, HB 2330 (2024), Certificates of need. oklegislature.gov
18. Oklahoma Legislature, Enrolled SB 1572 (2026), Health and mental health agency feasibility study. oklegislature.gov
19. Office of Governor Kevin Stitt, Josh Anderson named interim commissioner of ODMHSAS (June 5, 2026). oklahoma.gov

This guide summarizes Oklahoma statutes, rules and ODMHSAS and OHCA pages as of the date above. It is general information, not legal advice. Requirements change; confirm with ODMHSAS before you apply.