Louisiana Behavioral Health & Substance Use Licensing Guide

Licensing agency

LDH Health Standards Section (HSS)One behavioral health service provider (BHSP) license

Rules

LAC 48:I, Chapters 56 and 57Updated to ASAM 4th edition levels in January 2026

License fee

$600 initial, $600 renewalPlus $300 per off-site; license runs up to one year

Facility need review

Required for CPST, PSR and most residential SUDNo longer required for OTPs since May 15, 2026

Accreditation

Deemed status replaces periodic licensing surveysMedicaid requires CARF, COA or Joint Commission for many services

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

Who licenses behavioral health providers in Louisiana?

The Louisiana Department of Health (LDH), through its Health Standards Section (HSS). A single behavioral health service (BHS) provider license covers substance use treatment facilities, mental health clinics and any other entity that offers behavioral health services to the public.² Operating without the license is unlawful.²

Some settings are exempt or licensed separately, including hospitals, crisis receiving centers, psychiatric residential treatment facilities and therapeutic group homes, FQHCs, rural health clinics, and individual licensed practitioners or group practices working within their own licenses.² Opioid treatment programs must also follow protocols set by LDH's Office of Behavioral Health (OBH) and the State Opioid Treatment Authority (SOTA).² For Medicaid, the Healthy Louisiana managed care organizations (MCOs) and the Coordinated System of Care contractor contract with behavioral health providers and check their qualifications.¹¹

What a BHSP license can cover

The license lists the services, or modules, the provider may offer, and the provider may deliver only those.² The current application offers:⁴

• Residential substance use treatment: ASAM levels 3.1, 3.5 (adolescent and adult versions), 3.7 and 3.7-WM.
• Outpatient: a mental health clinic, mental health intensive outpatient, and ASAM levels 1.5, 2.1, 2.5 and 2.7.
• Opioid treatment: an opioid treatment program (OTP) and mobile dosing units, both subject to SOTA approval.
• Community mental health: psychosocial rehabilitation (PSR), crisis intervention, community psychiatric support and treatment (CPST) and mobile crisis response.
• Certified community behavioral health clinics (CCBHCs), which need an OBH pre-certification letter.

A license covers one address and one geographic service area. Off-sites need HSS approval and must sit in the same service area, which can reach 50 miles from one designated off-site. Residential off-sites go through plan review.²

Law and rules

The licensing law is R.S. 40:2151-2161, and the standards are in LAC 48:I, Chapters 56 and 57.² R.S. 40:2153 defines the financial viability every non-governmental provider must keep: a $50,000 line of credit, at least $500,000 in general and professional liability insurance, and workers' compensation coverage.¹⁰ Facility need review is governed by LAC 48:I, Chapter 125.⁷

How to apply for a BHSP license

1. Clear facility need review if it appliesGet FNR approval first if you will offer CPST, PSR or residential substance use treatment for anyone other than women and adolescents.^{3, 6}
2. Plan review and inspectionsOutpatient clinics and residential sites where care is delivered need Office of State Fire Marshal (OSFM) plan review, an OSFM occupancy inspection and an Office of Public Health inspection recommending licensure.^{2, 3}
3. Build the packetInclude the application, the fee, a letter of intent naming your services, an organizational chart, a floor sketch, Secretary of State registration, a disclosure of ownership form, proof of financial viability and state background checks on owners and managing employees dated within 90 days.^{2, 3}
4. Submit to HSSEmail the packet to the BHSP licensing inbox and mail the fee with the payment transmittal form. HSS gives you 90 days to supply anything missing.^{1, 2}
5. Initial surveyOnce the application is approved, tell HSS you are ready within 90 days or the file closes. HSS conducts an announced on-site survey, and may issue a provisional license of up to six months if the deficiencies found do not threaten clients.²

New providers may not treat clients until they hold the license.² Renewal packets are due at least 30 days before the license expires. A license cannot be sold or transferred, so a change of ownership needs its own application.^{2, 1}

Licensing fees

Licensing fees come from HSS's fee schedule and the FNR fee from its FNR page.^{5, 6}

How accreditation counts in Louisiana

Deemed status: once licensed, a provider accredited by an LDH-authorized accreditation organization can ask for deemed status. HSS then accepts accreditation in place of periodic re-licensure surveys. Every service on the license must be accredited, and the current accreditation goes in with each renewal.²

Survey waivers: deemed status does not replace the initial licensing survey. HSS still investigates complaints, and it may pull deemed status and survey after a valid complaint, a new service, a change of ownership or location, a provisional license or a serious incident. Losing accreditation ends deemed status, and changes must be reported within two business days.² The rule does not name the authorized accreditors.

Fee breaks: none are listed on the HSS fee schedule.⁵

Medicaid: the Medicaid manual requires CARF, COA or The Joint Commission accreditation for many services, including residential substance use treatment, OTPs, CPST, PSR, crisis intervention, crisis response, assertive community treatment and adult crisis stabilization. Most providers must apply and pay before an MCO contracts with them and reach full accreditation within 18 months; adult crisis stabilization has 12 months. CPST and PSR agencies need full or preliminary accreditation before contracting.¹¹

Opioid treatment: federal certification requires accreditation from a SAMHSA-approved body: CARF International, Social Current (formerly COA), The Joint Commission, the National Commission on Correctional Health Care or the Washington State Department of Health.¹³

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

Opioid treatment programs

• Facility need review ended: Act 232 of 2026 (SB 26) repealed the statutory FNR requirements for OTPs, effective May 15, 2026. LDH confirms that OTPs no longer need FNR.^{9, 1} Before that, LDH licensed new OTPs only after a needs assessment and a competitive request for applications.⁷
• State rules: OTPs follow OBH and SOTA protocols, update the state methadone central registry daily, report client deaths to SOTA within 24 hours and run at least eight random drug screens per client each year.²
• Hours: at least six days a week, including one weekend day, on SOTA-approved hours. Closures are allowed on Sundays and eight listed holidays.²
• Mobile dosing units: an OTP with a valid license, SAMHSA certification and SOTA approval can add one through HSS. Each unit serves one SOTA-approved location a day in the parent's LDH region.²
• Federal steps: state licensure and DEA registration come before SAMHSA's one-year provisional certification, and the program must be accredited within that year.¹²

Other approvals you may need

• Facility need review: CPST and PSR applicants must show that clients would face serious access problems without them. Approvals are tied to the location and service area, cannot be transferred and expire if you are not licensed within a year.⁷ Since August 1, 2024, residential substance use treatment needs FNR unless it serves women, adolescents or both. Providers already licensed or applying before that date were grandfathered.⁸
• Medicaid enrollment: providers must enroll in Medicaid to bill fee-for-service or dual-eligible claims. Healthy Louisiana MCOs check that contracted providers meet the manual's qualifications.¹¹
• Medications for opioid use disorder: residential substance use facilities that treat opioid use disorder must provide on-site access to an FDA-approved opioid antagonist and a partial agonist, and attest to it on each application.²
• Recovery residences: since August 1, 2026, a court-referral housing facility may not offer residential substance use treatment unless it holds a BHSP license with that module, and judicial agencies may refer only to licensed facilities.¹⁷ SB 472 of 2026, which would have had LDH set minimum standards for sober living homes, stayed in Senate committee.¹⁸

Recent changes

• January 20, 2026: the Chapter 56 and 57 rule renamed the ASAM levels to the 4th edition, repealed levels 3.2-WM and 3.3, restored the pregnant and parenting women program and clarified OTP hours. Providers had to comply by July 1, 2026, with license changes made at renewal.^{14, 15}
• May 15, 2026: Act 232 ended facility need review for OTPs.⁹
• August 1, 2026: Act 514 (SB 437) tied court-referral housing that offers residential SUD treatment to the BHSP license.¹⁷
• October 20, 2026: a new CCBHC module (Subchapter P) was adopted in the Louisiana Register.^{16, 15} The September 2026 application adds CCBHC services.⁴

Confirm these with LDH

• Which accreditors LDH authorizes for deemed status; the rule does not list them.
• How the $5 per-unit fee is counted for your license.
• Whether the OTP sections of LAC 48:I, Chapter 125 have been formally repealed to match Act 232.
• Whether your service area and population trigger facility need review, and current FNR processing times.
• For OTPs: SOTA requirements and approval timing, and the OBH letter the initial checklist asks for.
• For CCBHCs: the OBH pre-certification and training steps required before licensure under Subchapter P.

Sources

1. Louisiana Department of Health, Behavioral health service provider. ldh.la.gov
2. Louisiana Administrative Code, LAC 48:I, Chapters 56 and 57, Behavioral health service providers (January 2026). ldh.la.gov
3. Louisiana Department of Health, BHSP initial licensing checklist. ldh.la.gov
4. Louisiana Department of Health, BHSP license application HSS-BH-01 (September 2026). ldh.la.gov
5. Louisiana Department of Health, HSS fee schedule. ldh.la.gov
6. Louisiana Department of Health, Facility need review. ldh.la.gov
7. Louisiana Administrative Code, LAC 48:I, Chapter 125, Facility need review. ldh.la.gov
8. Louisiana Department of Health, Act 692 FNR memo for residential substance abuse treatment (September 25, 2024). ldh.la.gov
9. Louisiana Legislature, SB 26 (Act 232 of 2026), Opioid treatment programs. legis.la.gov
10. Louisiana Revised Statutes, R.S. 40:2153, Definitions. legis.la.gov
11. Louisiana Medicaid, Medicaid Services Manual Chapter 2, Behavioral health services. lamedicaid.com
12. SAMHSA, Become an opioid treatment program. samhsa.gov
13. SAMHSA, Approved accreditation bodies. samhsa.gov
14. Louisiana Department of Health, Regulatory updates to align with ASAM 4th edition (February 4, 2026). ldh.la.gov
15. Louisiana Department of Health, BHSP rulemaking. ldh.la.gov
16. Office of the State Register, Louisiana Register, Vol. 52, No. 10 (October 20, 2026). doa.la.gov
17. Louisiana Legislature, SB 437 (Act 514 of 2026), Facilities housing individuals referred by judicial agencies. legis.la.gov
18. Louisiana Legislature, SB 472 (2026), Sober living homes. legis.la.gov

This guide summarizes Louisiana statutes, rules and LDH and Medicaid pages as of the date above. It is general information, not legal advice. Requirements change; confirm with the LDH Health Standards Section before you apply.