Wisconsin Behavioral Health & Substance Use Licensing Guide

Certifying agency

DHS Division of Quality Assurance (DQA)Behavioral Health Certification Section

Main rules

DHS 75 (substance use) and DHS 35 (outpatient mental health)DHS 75 was rewritten effective October 1, 2022

Applications

DHS DQA Provider PortalDQA decides within 60 days of a complete application

Opioid treatment

DHS 75.59 certification plus SOTA approvalState certification runs 3 years, matching the federal period

Certificates

Non-expiring, with a biennial report and feeDHS 35, 36 and 75 contain no deemed status for accredited programs

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

Who certifies behavioral health programs in Wisconsin?

The Department of Health Services (DHS). Within DHS, the Division of Quality Assurance's Behavioral Health Certification Section, part of the Bureau of Assisted Living, certifies both substance use and mental health treatment programs.³ Wisconsin uses the word certification rather than licensure for these programs.

Who needs it: DHS 75 covers public and private facilities that provide substance use treatment, programs approved by the State Opioid Treatment Authority (SOTA), services that need certification under a DHS funding contract, intoxicated driver services and any service that asks to be certified. Treatment delivered by telehealth to a patient in Wisconsin counts as practice in the state, wherever the provider sits.⁴ DHS says outpatient clinics that offer substance use treatment must hold DHS 75 certification.⁹ DHS 35 applies to outpatient mental health clinics that bill Medicaid, BadgerCare Plus or insurers under the state mandate, or that use federal block grant or state community aids funds.⁵

Other DHS players: the SOTA oversees opioid treatment programs,⁴ and ForwardHealth runs Wisconsin Medicaid enrollment and billing.¹⁴

Certification types

DHS 75 certifies each service separately:^{2, 4}

• Prevention and intervention: prevention (75.14); intervention and intoxicated driver services (75.15).
• Outpatient: outpatient substance use treatment (75.49), outpatient integrated behavioral health treatment (75.50), intensive outpatient (75.51) and day treatment or partial hospitalization (75.52).
• Residential and inpatient: transitional residential (75.53), medically monitored residential (75.54), medically managed inpatient (75.55), adult residential integrated behavioral health stabilization (75.56), residential withdrawal management (75.57) and residential intoxication monitoring (75.58).
• Medications for opioid use disorder: opioid treatment programs and their mobile units (75.59) and office-based opioid treatment (75.60).

Mental health certifications include crisis urgent care and observation facilities (DHS 31), crisis hostels (DHS 33), emergency mental health services (DHS 34), outpatient mental health clinics (DHS 35), comprehensive community services (DHS 36), youth day treatment (DHS 40), youth crisis stabilization facilities (DHS 50), inpatient and day treatment programs (DHS 61.71, 61.75 and 61.79) and community support programs (DHS 63).¹

Branch offices: any site where treatment is given on a regular basis, other than a school, goes on the main certificate as a branch office and may offer the same services. Residential and inpatient services cannot have branch offices.⁹ A DHS 35 clinic likewise lists every office in its application rather than certifying each one.⁵

Law and rules

DHS 75, Community Substance Use Service Standards, was repealed and recreated by Clearinghouse Rule 20-047, effective October 1, 2022. It rests on ss. 46.973, 51.42, 51.4224 and 51.45 of the Wisconsin Statutes.⁴ Outpatient mental health clinics follow DHS 35,⁵ and comprehensive community services (CCS) programs follow DHS 36, which applies only to county departments and tribes.⁶ Section 51.04 lets a treatment facility seek certification so it can be paid through Medicaid, community aids or mandated insurance coverage.¹¹ Opioid treatment programs are also governed by ss. 51.4223 and 51.4224.¹⁰

How to apply for DHS 75 or DHS 35 certification

1. Choose your servicesRead the rule for each service you plan to offer. DHS posts a how-to video for each DHS 75 service type.²
2. Write policies and proceduresA DHS 75 application must include the policies the chapter requires and the fees.⁴ A DHS 35 application adds proof of malpractice and liability insurance for the clinic and for each prescriber or psychotherapist.⁵
3. Prepare a residential siteResidential applicants add a floor plan, a 24-hour staffing plan, municipal zoning approval or an occupancy permit and a fire inspection from the past 12 months. Buildings must meet the DHS 83 design standards,⁴ and construction plans for DHS 75.53 to 75.58 facilities go through the Provider Portal.⁸
4. Apply in the Provider PortalInitial applications, added services or branches, ownership changes, amendments and renewals all go through the DHS DQA Provider Portal.^{1, 2} Background checks for entity operators are requested there too, and fees can be paid online.⁸
5. Review and decisionDQA approves or denies within 60 days of a complete application.^{4, 5} For DHS 35 clinics, staff may inspect any listed office and review records first.⁵

After certification: since 2023, DHS 34, 35, 36, 61, 63 and 75 certificates have no expiration date. DQA reissues one only when services or branch offices change. Instead of an annual renewal, providers sign a biennial summary report, update staffing and pay the biennial fee; on-site surveys continue every two years.⁷ A DHS 35 certification lapses if the biennial report and fee are not filed in time.⁵

Ownership changes: under DHS 75, the seller tells DHS at least 30 days ahead, the buyer files a complete application at least 30 days before the transfer, and clients get at least 7 days' notice.⁴

Certification fees

The rules tie fees to ss. 51.04 and 51.45(8)(a) but set no dollar amounts.^{4, 5} Section 51.04 directs DHS to charge an annual fee for each certification,¹¹ while the rules and DQA's 2024 memo describe a fee paid every two years.⁷ We found no current fee schedule on DHS's certification pages,^{1, 2} so get the amounts from DQA before you budget. Registry details are on DHS's registry page.¹³ The opioid treatment row comes from DHS 75.06 and s. 51.4223.^{4, 10}

How accreditation counts in Wisconsin

No deemed status: the certification chapters DHS 35, 36 and 75 contain no provision that accepts CARF, Joint Commission or COA accreditation in place of state certification, waives the state survey or reduces fees.^{4, 5, 6} DQA's biennial on-site surveys continue for certified programs.⁷

Medicaid: ForwardHealth ties residential SUD enrollment to DQA certification and an IMD determination, not to accreditation.¹⁴

Opioid treatment: this is where accreditation is required. Federal rules require a new OTP to be accredited within its one-year provisional SAMHSA certification.²³ 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.²⁴ DHS 75.59 also requires an OTP to meet its accreditor's physical facility standards, and the SOTA may use accreditor performance indicators to monitor outcomes.⁴

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

Opioid treatment programs

• Two layers of state rules: an OTP must be certified under DHS 75.50 (outpatient integrated behavioral health), meet the general treatment rules and follow DHS 75.59. Where they conflict, 75.59 wins.⁴
• SOTA approval and need: applicants send the SOTA copies of their federal applications and DEA registration request, a service narrative, documentation of need, admission criteria, the policy manual, proof of adequate facilities and medical backup, and a list of staff licensed to handle narcotics. The SOTA works with other agencies to judge need in a proposed location, using data such as overdose deaths, ambulance runs and hospitalizations.⁴
• Approved sites only: a site must be approved by SAMHSA, DEA and the SOTA. Each medication unit needs its own DHS approval before it opens, and DHS weighs how patients and existing units are spread across the area.⁴ Mobile units apply through the Provider Portal.²
• Term and reporting: state OTP certification lasts 3 years and lines up with the federal certification period. Programs report staffing ratios, take-home doses, patients by medication and other data to DHS every year.¹⁰
• Staffing: a medical director with at least a year of addiction medicine or addiction psychiatry experience, a registered nurse on site whenever dosing occurs and one full-time counselor for every 55 patients.⁴
• Limits on the state: DHS may not cap how long a patient stays in treatment or require patients to live within a set distance of the clinic.¹⁰
• Office-based treatment: DHS 75.60 certification covers stand-alone office-based opioid treatment. It does not apply to hospitals, primary care, correctional facilities, practices treating fewer than 30 patients with medication, or services whose medication patients are all enrolled in another DHS 75 service.^{4, 9}
• Federal steps: state approval and DEA registration come before SAMHSA provisional certification.²³

Other approvals you may need

• Medicaid enrollment: providers enroll through the ForwardHealth Portal. Since February 1, 2021, Medicaid has covered residential SUD treatment in DQA-certified medically monitored and transitional residential facilities, including IMDs, under the BadgerCare Reform 1115 waiver. DQA certification comes first, and residential applicants must obtain an IMD determination (form F-02746) before enrolling.¹⁴ The benefit now cites DHS 75.54 and 75.53 and excludes sober living homes and recovery residences.¹⁵
• Comprehensive community services: only counties and tribes are certified under DHS 36.⁶ Private DHS 35 clinics and DHS 75 programs can contract with a CCS program to provide psychotherapy or substance use treatment.¹⁸
• Recovery residences: DHS keeps a voluntary registry under s. 46.234, created by 2019 Wisconsin Act 120. A residence must register only if it wants state referrals or state or federal pass-through funds. Registered homes must meet listed standards, cannot turn away residents only for using medication for addiction treatment, and alone may call themselves registered or state approved.¹² Apply on form F-02706 by email. DHS adds a home 60 days after a complete application and asks for a new application every year.¹³
• Peer recovery and overdose treatment: DHS 72 certifies peer recovery support services and overdose treatment providers. Programs already certified under DHS 75 do not need DHS 72 certification.⁹

Recent changes

• August 11, 2025: emergency rule EmR2511 changed DHS 75 and the Medicaid rules on substance use services. It was extended to May 7, 2026 and has expired.²¹
• December 2025: the DHS DQA Provider Portal opened, and substance use and mental health programs were among the first required to use it.⁸
• March 1, 2026: Clearinghouse Rule 25-055 amended several DHS 75 sections, including the client notice for a change of ownership.⁴
• April 1, 2026: Medicaid began covering peer recovery support services, up to 520 hours a year. Residential SUD programs can no longer count peer services toward weekly treatment hours and bill them separately instead.¹⁶
• October 1, 2026: an integrated behavioral health day treatment benefit replaced the substance abuse day treatment benefit. DHS 75.52 programs can now offer SUD, mental health or co-occurring day treatment to members of any age, with prior authorization.¹⁷
• October 13, 2026: emergency rule EmR2610 created DHS 33 for crisis hostels. Comments are open through November 9, 2026.²²
• Pending, CR 25-054: the permanent DHS 75 and Medicaid revision. DHS proposes dropping the DATA 2000 waiver requirement, aligning Medicaid with intensive outpatient and day treatment, and letting DHS 35 clinics and rural health clinics treat co-occurring SUD without separate DHS 75 certification.²⁰ DHS recalled and resubmitted it with changes on October 8, 2026.¹⁹

Confirm these with DHS

• Current initial and biennial certification fees, which DHS does not publish on its certification pages, and how the annual fee in s. 51.04 fits the two-year cycle.
• The final text and effective date of CR 25-054, especially the co-occurring care exemption for mental health and rural health clinics.
• Whether your outpatient model needs DHS 35, DHS 75.50 or both.
• For opioid treatment programs: what the SOTA expects as documentation of need for your location, and the order of state, DEA and SAMHSA filings.
• For residential programs: plan review steps and the IMD determination before Medicaid enrollment.
• Recovery residence registry timing and any standards your certifying organization must meet.

Sources

1. Wisconsin DHS, Mental health treatment programs: certification. dhs.wisconsin.gov
2. Wisconsin DHS, Substance use treatment programs: certification. dhs.wisconsin.gov
3. Wisconsin DHS, Division of Quality Assurance bureaus and offices. dhs.wisconsin.gov
4. Wisconsin Administrative Code, Chapter DHS 75, Community substance use service standards. docs.legis.wisconsin.gov
5. Wisconsin Administrative Code, Chapter DHS 35, Outpatient mental health clinics. docs.legis.wisconsin.gov
6. Wisconsin Administrative Code, Chapter DHS 36, Comprehensive community services. docs.legis.wisconsin.gov
7. Wisconsin DHS, DQA Memo 24-001, Behavioral health providers non-expiring certificates. dhs.wisconsin.gov
8. Wisconsin DHS, DHS DQA Provider Portal. dhs.wisconsin.gov
9. Wisconsin DHS, Substance use: provider information. dhs.wisconsin.gov
10. Wisconsin Statutes, ss. 51.4223 and 51.4224, Opioid treatment reporting and certification. docs.legis.wisconsin.gov
11. Wisconsin Statutes, s. 51.04, Treatment facility certification. docs.legis.wisconsin.gov
12. Wisconsin Statutes, s. 46.234, Recovery residences; registration. docs.legis.wisconsin.gov
13. Wisconsin DHS, Recovery residence registry. dhs.wisconsin.gov
14. ForwardHealth, Update 2020-42, New benefit for residential substance use disorder treatment. forwardhealth.wi.gov
15. ForwardHealth, Residential substance use disorder treatment benefit resources. forwardhealth.wi.gov
16. ForwardHealth, Update 2026-05, New coverage for peer recovery support services. forwardhealth.wi.gov
17. ForwardHealth, Update 2026-27, New behavioral health day treatment benefit. forwardhealth.wi.gov
18. Wisconsin DHS, Comprehensive community services: provider resources. dhs.wisconsin.gov
19. Wisconsin Legislature, Clearinghouse Rule CR 25-054. docs.legis.wisconsin.gov
20. Wisconsin DHS, Rulemaking report to the Legislature, CR 25-054. docs.legis.wisconsin.gov
21. Wisconsin Legislature, Emergency rule EmR2511. docs.legis.wisconsin.gov
22. Wisconsin Legislature, Emergency rule EmR2610, Crisis hostels. docs.legis.wisconsin.gov
23. SAMHSA, Become an opioid treatment program. samhsa.gov
24. SAMHSA, Approved accreditation bodies. samhsa.gov

This guide summarizes Wisconsin statutes, administrative rules and DHS and ForwardHealth publications as of the date above. It is general information, not legal advice. Requirements change; confirm with DHS before you apply.