For anyone in Montana planning, buying, expanding or keeping a licensed addiction or mental health program, from first-time owners to the clinical leads who will run it.
Additional Montana Licensing Guides
- Montana Drug and Alcohol Inpatient Treatment Licensing
- Montana Drug and Alcohol Outpatient Treatment Licensing
- Montana Mental Health Inpatient Licensing
- Montana Mental Health Outpatient Licensing
- Montana License Reinstatement
In Montana, the Name on Your Accreditation Certificate Changes the Inspection
The statutes and rules quoted in this section were read on the Montana Legislature’s and the Administrative Rules of Montana sites. The comparison of accreditors at the end is our reading of them together.
Montana writes accreditation into its facility licensing statute, and it does so with a condition most operators skim past. Under MCA 50-5-103(4), a facility accredited by “an accrediting entity approved by the U.S. centers for medicare and medicaid services” is eligible for licensure for the period of that accreditation and “may not be subjected to an inspection by the department for purposes of the licensing process.” The department keeps its power to inspect when someone files a written complaint, limited to the area the complaint concerns. The licensing rule, ARM 37.106.310(3), adds the reward: a facility with that kind of accreditation can be issued a license for up to three years, provided it hands the department the full accreditation report.
The catch sits in which accreditors count. On the CMS page naming approved accreditors, The Joint Commission appears. CARF and COA are absent. Montana’s other behavioral health statute goes the other way. MCA 53-24-208(9), which governs state approval of substance use disorder programs, names “the commission on accreditation of rehabilitation facilities” and lets a CARF-accredited program be considered eligible for that approval, while still requiring the department to inspect it. Put side by side, our reading is that a Joint Commission accreditation can take the place of the licensing survey, and CARF helps with the state approval file but leaves both inspections in place. CMS approval is also granted program by program, so confirm with the licensing office that your specific accreditation qualifies before you count on skipping a survey.
The statute itself was rewritten recently. Senate Bill 516, enacted as Chapter 414 of the 2025 Laws and effective October 1, 2025, added the term “substance use disorder facility” to MCA 50-5-101, moved the application deadline to at least 45 days before opening, and widened an attestation requirement the statute already had so that it now reaches every facility type. Each applicant files an attestation or supporting documentation showing it has read and understands the licensure requirements for its kind of facility. Some agency paperwork still uses the older “chemical dependency” wording, including the official title of the rule subchapter.
Primary Regulatory Agencies
Each role is described from the agency’s own web page or governing law.
- Department of Public Health and Human Services (DPHHS), Office of Inspector General, Licensure Bureau, which licenses substance use disorder facilities, mental health centers, specialty mental health facilities, hospitals and outpatient facilities under MCA Title 50, chapter 5
- DPHHS Behavioral Health and Developmental Disabilities Division (BHDD), whose Treatment Bureau handles “State Approval” of substance use disorder programs under MCA 53-24-208, a separate step that requires an active facility license first
- Montana Board of Behavioral Health (Department of Labor and Industry), which licenses addiction counselors and other behavioral health professionals under MCA Title 37, chapter 39
Montana Behavioral Health Licensing Snapshot
Every row paraphrases the statute or rule it names. The CON row is our reading of the Montana CON statute together with the licensing office’s own application letter.
| Primary SUD Regulator | DPHHS Office of Inspector General, Licensure Bureau (facility license), plus BHDD state approval for programs that seek it |
| Mental Health Facility Licensing | The same Licensure Bureau licenses mental health centers (ARM 37.106 Subchapter 19), specialty mental health facilities and hospitals, psychiatric hospitals included |
| Residential Treatment | Licensed by ASAM level in ARM 37.106 Subchapter 14: 3.1, 3.3 (adults only), 3.5 and 3.7 |
| Outpatient Treatment | Outpatient substance use disorder facility and ASAM 2.5 partial hospitalization under Subchapter 14. Outpatient mental health runs through a mental health center license |
| Withdrawal Management | ASAM 3.2-WM and 3.7-WM under ARM 37.106.1480. A 3.7-WM provider must hold an inpatient SUD facility license |
| Facility License Required | Yes. Under MCA 50-5-201 no one may run a health care facility unless the department has licensed it. Physician offices and other Title 37 practitioner offices fall outside the definition in MCA 50-5-101 |
| Certificate of Need | Not for behavioral health. MCA 50-5-301 is written around long-term care facilities, and the bureau’s SUD letter states these facilities skip Health Planning Program review |
| National Accreditation | Not required. CMS-approved accreditation (The Joint Commission, for example) exempts a facility from licensing inspections and qualifies it for a three-year license. CARF counts toward BHDD state approval eligibility only |
| Inspection | Initial inspection within 45 days of notice that the facility is ready, then an unannounced inspection before each license expires (MCA 50-5-204). BHDD inspects approved SUD programs every two years |
| License Renewal | License terms run one to three years. Statutory fee of $20 for 20 beds or fewer and $1 per bed for 21 or more (MCA 50-5-202) |
| Key Regulations | MCA 50-5-101 to 50-5-208, MCA 53-24-208, ARM 37.106.310, ARM 37.106 Subchapters 14, 17 and 19, ARM 37.27.106, MCA Title 37, chapter 39 |
How Montana’s Pieces Fit Each Program
We built this grid ourselves from the rules cited in it. No DPHHS publication lines the programs up this way.
| Program | License and rule | Second step | Certificate of Need |
|---|---|---|---|
| Residential SUD treatment (ASAM 3.1 to 3.7) | OIG, SUD facility license, ARM 37.106 Subchapter 14 | BHDD state approval if the program wants it, with a county-level local need showing | No |
| Withdrawal management (3.2-WM, 3.7-WM) | OIG, ARM 37.106.1480 | Same BHDD route | No |
| Outpatient SUD and partial hospitalization | OIG, outpatient SUD facility (37.106.1468) or ASAM 2.5 (37.106.1469) | Same BHDD route | No |
| Outpatient mental health | OIG, mental health center license, ARM 37.106 Subchapter 19 | None found | No |
| Adult crisis stabilization and group homes | Endorsements on a mental health center license | State Fire Marshal approval for these endorsements | No |
| Psychiatric hospital | OIG, hospital license under MCA Title 50, chapter 5 | None found | No |
| Solo or group clinician office | Outside facility licensing under MCA 50-5-101(20)(b), which becomes (21)(b) when the statute’s January 1, 2027 version takes effect | Individual Board of Behavioral Health licenses | No |
Montana is one of the states that writes ASAM level numbers straight into the license rules, and BHDD’s approval rule tells approved programs to “follow the ASAM Criteria.” Even so, a license reading ASAM 3.7 is the state’s judgment about your program, not ASAM’s. If you want a second, independent check on the level, ASAM and CARF jointly run a Level of Care Certification (see ASAM’s description) that currently reaches only adult programs at 3.1, 3.5 and 3.7. OIG prints nothing about it on the license. A referring clinician or discharge planner can still confirm it in CARF’s provider search, which has a certification filter for each of those three levels. CARF and ASAM both describe the program in residential terms only, so in our reading a 3.7-WM unit falls outside it. Montana’s 3.3 level has no CARF certification counterpart either.
Programs Covered
- Residential SUD treatment at ASAM 3.1, 3.3, 3.5 and 3.7
- Clinically managed and medically monitored withdrawal management
- Outpatient SUD treatment, intensive outpatient and partial hospitalization
- Mental health centers, including adult inpatient crisis stabilization and group home endorsements
- Psychiatric hospitals and specialty mental health facilities
Key Licensing Requirements
Drawn from the Licensure Bureau’s application letters and the statutes they rest on.
- An initial application through the OIG online portal at mt-reports.com, filed at least 45 days before opening but no more than six months before the date you want the license
- Written policies and procedures delivered at least 45 days before the expected opening date
- For residential sites, a floor plan, a plan submittal to the Licensure Bureau’s construction consultant and State Fire Marshal certification, plus well water and septic reports where they apply
- An attestation or supporting documentation that the applicant has read and understands its facility type’s licensing rules, a requirement SB 516 extended to all facility types in MCA 50-5-203
- For SUD programs seeking BHDD state approval, the Facility State Approval Application with the facility license, a site list and documentation of local need for each county served
Frequently Asked Questions
What does a Montana behavioral health license cost?
MCA 50-5-202 is the only fee source we could pin down. It charges $20 when a facility has up to 20 beds and $1 a bed once it reaches 21. The licensing office’s application letters print no amount, and its portal pages sit behind a reCAPTCHA, so we have not verified what OIG actually collects at filing or what a no-bed outpatient site pays. Ask the Licensure Bureau before you budget. Building work, fire and plan review items and the payroll you carry before opening will dwarf the state fee either way.
How long does it take to get licensed in Montana?
The state publishes the steps but no overall timeline. You file no more than six months ahead, at least 45 days before opening, and OIG must inspect within 45 days after you report the facility is ready. Approval of all items brings a six-month provisional license, with an on-site survey during that period. Our own estimate, built from those steps, is about three to five months to a provisional license for an outpatient program and five to eight months for residential, where plan review, fire marshal sign-off and building approvals add time. BHDD state approval comes after the license, with 30-day windows for missing items.
Where do Montana applicants most often lose time?
Treating the OIG license as the finish line. SUD programs that want BHDD state approval face a second application that requires the license first, a local need showing for every county they plan to serve, and a refusal to accept telehealth coverage of all counties as that showing. The other frequent snag is accreditation. Owners holding CARF expect to skip the licensing survey and find that the inspection exemption in MCA 50-5-103 is tied to CMS-approved accreditors, a list CARF is not on.
Can a Montana license be guaranteed?
No. The Licensure Bureau decides, and MCA 50-5-207 lets it deny a license for reasons that range from unmet standards to too few qualified staff. A complete file, written against the current Subchapter 14 or Subchapter 19 rules and sequenced so the license and any state approval line up, is what an applicant can actually control.
How much staff will a Montana program need?
It depends on the level. For an outpatient SUD facility the rule lists a clinical director, enough counselors and care managers to serve the caseload, and a crisis phone line answered at all hours. Residential 3.7 is heavier: a medical director, a prescriber reachable on call day and night, and a nurse (RN or LPN) physically present every hour. For substance abuse, behavioral disorder and mental health counselors in Montana, BLS reports a $59,000 median, a 25th percentile of $46,170 and a 75th of $74,010 (BLS OEWS, May 2025). The national median in that release was $59,350. Pay three counselors the Montana median and wages alone reach roughly $177,000 a year, with benefits, supervision and overnight coverage still to add. A new Montana program does not have to fill every counseling seat with a fully licensed clinician. The Board of Behavioral Health licenses addiction counselor candidates who have finished their education but still owe at least 1,000 supervised hours spread over seven months or more, under a filed training and supervision plan. Hiring candidates at candidate wages, supervised by a licensed clinical director, commonly lowers counseling payroll by 40 to 60 percent compared with a roster of fully licensed staff. Nursing follows the same logic, since Montana’s 3.7 rule already places LPNs under RN supervision, so a single RN can lead several LPNs instead of staffing RNs on every shift. Exact headcount follows from the levels and bed count you choose.
Licensing
Is it one license or two for a Montana SUD program?
One license, from one office, with a possible second approval from a different division. The Licensure Bureau’s facility applications page lists “Substance Use Disorder Facilities” and “Mental Health Center” as separate application tracks. BHDD state approval is not a license. Under ARM 37.27.106, as amended by MAR Notice No. 2026-170 (effective August 22, 2026 under the rule’s history line, and DPHHS says it intends the amendment to apply from October 1, 2025), a facility “must be state approved and licensed pursuant to ARM Title 37, chapter 106, subchapter 14” to be reimbursed for facility-based SUD services. Whatever a program decides about that, the approval process itself (local need, ASAM Criteria, biennial BHDD inspection) shapes how many Montana programs plan their first year.
Does a Montana mental health license cover addiction care?
Partly. ARM 37.106.1906 makes “chemical dependency services” one of five services every mental health center must provide. Under ARM 37.106.1902 that means screening at intake, an LAC evaluation if the screen points to one, LAC or state-approved program treatment that the center can deliver itself or line up elsewhere, and keeping that treatment tied to the client’s mental health care. The rules do not say where this ends and a separately licensed SUD facility begins. Our reading is that LAC counseling inside a center fits the definition, while a program run at an ASAM level of care belongs under a Subchapter 14 license, and that line is worth confirming with the Licensure Bureau.
What did SB 516 change?
Chapter 414 of the 2025 Laws took effect October 1, 2025. Beyond the new “substance use disorder facility” term and the 45-day filing floor, it widened the reasons OIG can place a facility on a provisional license, which can now run for up to one year under MCA 50-5-207. The SUD licensing rules themselves have not changed since September 24, 2022, and still define the facility by reference to a “chemical dependency facility” term the statute no longer uses.
Facility
Does Montana have Certificate of Need for behavioral health?
No. Montana’s CON statute, MCA 50-5-301, is triggered by long-term care beds, services and projects. For addiction programs the Licensure Bureau’s letter puts it plainly: they “are not required to be reviewed by the Health Planning Program.” BHDD’s local need showing for state approval is the closest Montana comes to a need test for addiction programs.
What does a residential site need before OIG will license it?
Expect to send a dimensioned floor plan, a BFS plan submittal form for the bureau’s construction consultant, sign-off from the local building authority (a certificate of occupancy if the building is new), certification from the State Fire Marshal or a designee, a lab potability report if the site runs on a well, and a county septic inspection if it is off city sewer.
Can a license move with a sale?
No. MCA 50-5-201 says a license “may not be sold, assigned, or transferred,” and the OIG portal handles a change of ownership as a new application.
Staffing
Who licenses addiction counselors in Montana?
The Board of Behavioral Health, under MCA Title 37, chapter 39, which replaced the old addiction counselor chapter in 2023. Under the board’s current rules an LAC applicant needs 285 contact hours in addiction studies (ARM 24.219.5006), a supervised stretch of no less than seven months and 1,000 hours in an addiction treatment program (ARM 24.219.5008), and a passed exam from the approved list in ARM 24.219.403, such as NCC AP Level 1 or 2 or the IC&RC ADC or AADC. Older board checklists that list 330 hours predate the current rule.
What does an ASAM 3.7 program have to staff?
ARM 37.106.1475 lists the roles. A medical director oversees treatment and medications. A physician, nurse practitioner or physician assistant must be reachable on call at any hour, an RN must supervise nursing from on site or on call, and an RN or LPN must be in the building all day and night. Licensed addiction counselors or mental health professionals have to be on site or on call for 16 hours of every day. A 3.7-WM unit needs an RN on site at all hours. The rules set no numeric staff-to-client ratio.
Operations
How does MOUD fit a Montana SUD facility?
ARM 37.106.1457(11) says a facility “cannot require clients to discontinue the use of any medication prescribed by a licensed health care professional for admission.” Prescribers no longer need the old X-waiver for buprenorphine. DEA’s Dear Registrant letter of January 12, 2023 dropped that requirement, leaving an ordinary DEA registration as the credential. Methadone for opioid use disorder stays with separately licensed opioid treatment programs, and a residential program would arrange that piece with one.
What incidents must be reported?
ARM 37.106.1426 gives an SUD facility 24 hours to send the OIG Licensure Bureau a written report of any serious incident. The rule’s list of ten events runs from a death or suicide attempt to restraint use, a bomb threat and alleged criminal activity. In the Subchapter 19 mental health center rules we found no comparable duty to report incidents to OIG, only an internal incident file and quality review.
Enforcement
What can OIG do when a facility falls short?
It can issue a corrective action order, which may stop admissions and becomes final unless a written hearing request arrives within 30 days (MCA 50-5-114). It can drop the facility to a provisional license, or deny, suspend or revoke the license under MCA 50-5-207, and a revocation order can keep the license revoked for up to two years. On a petition from the department or the county attorney, a court may also impose up to $1,000 for each day of violation (MCA 50-5-112). More on recovering from a revocation is in Montana License Reinstatement.
What hearing rights apply?
MCA 50-5-208 bars a denial, suspension or revocation without notice and a chance for a hearing, with notice at least 15 days ahead. Once mailed or served, the department’s decision turns final after 30 days unless the licensee appeals to the district court for the county where the facility is or will be located.
What We Take On in Montana
Where we help
Matching a program to the right Subchapter 14 level or mental health center endorsement, assembling the OIG portal application and the policies due 45 days before opening, sequencing BHDD state approval behind the license, and deciding whether Joint Commission or CARF accreditation fits the inspection and approval goals described above.
Where we refer out
Billing, payer enrollment and contracts with public or private payers, along with marketing, sit outside our work. If you need someone for those, we can point you to people who do it.
Weighing Joint Commission against CARF for a Montana program? Start a conversation with us.
Author: A. Ant, CADC-II, Licensing & Accreditation Expert
Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.
Sources
- DPHHS Office of Inspector General, Licensure Bureau, facility applications (license tracks): Health Care and Community Residential Facility Applications (checked October 15, 2026)
- DPHHS OIG, Substance Use Disorder Initial Application Letter (filing window, provisional license, site items, Health Planning): SUDF application letter (PDF) (checked October 15, 2026)
- DPHHS OIG, Mental Health Center Initial Application Letter (Fire Marshal approval for endorsements): MHC application letter (PDF) (checked October 15, 2026)
- OIG online license portal (initial and change of ownership applications): License list (checked October 15, 2026)
- DPHHS Behavioral Health and Developmental Disabilities Division (Treatment Bureau, state approval): BHDD (checked October 15, 2026)
- BHDD, Facility State Approval Application (local need, telehealth): State approval application (PDF) (checked October 15, 2026)
- ARM 37.27.106 as amended, MAR Notice No. 2026-170 adoption: MAR 2026-170 adoption notice (PDF) (checked October 15, 2026)
- MCA 50-5-101 (definitions, office exclusion): MCA 50-5-101 (checked October 15, 2026)
- MCA 50-5-103 (accreditation and licensing inspections): MCA 50-5-103 (checked October 15, 2026)
- MCA 50-5-112 (civil penalty): MCA 50-5-112 (checked October 15, 2026)
- MCA 50-5-114 (corrective action orders): MCA 50-5-114 (checked October 15, 2026)
- MCA 50-5-201 (license required, not transferable): MCA 50-5-201 (checked October 15, 2026)
- MCA 50-5-202 (license fee): MCA 50-5-202 (checked October 15, 2026)
- MCA 50-5-203 (application timing and attestation): MCA 50-5-203 (checked October 15, 2026)
- MCA 50-5-204 (inspections, license term): MCA 50-5-204 (checked October 15, 2026)
- MCA 50-5-207 (denial, provisional license, revocation): MCA 50-5-207 (checked October 15, 2026)
- MCA 50-5-208 (hearings): MCA 50-5-208 (checked October 15, 2026)
- MCA 50-5-301 (Certificate of Need, long-term care): MCA 50-5-301 (checked October 15, 2026)
- MCA 53-24-208 (state approval, local need, CARF): MCA 53-24-208 (checked October 15, 2026)
- 2025 Mont. Laws Chapter 414 (SB 516): Chapter 414 session law (PDF) (checked October 15, 2026)
- MCA 1-2-201 (default October 1 effective date): MCA 1-2-201 (checked October 15, 2026)
- ARM 37.106.310 (license term tiers, accreditation report), Administrative Rules of Montana: ARM 37.106.310 (checked October 15, 2026)
- ARM 37.106 Subchapter 14 (SUD facility rules, incl. 1411, 1426, 1457, 1468, 1469, 1475, 1480), Administrative Rules of Montana: Subchapter 14 (checked October 15, 2026)
- ARM 37.106.1906 (mental health center core services), Administrative Rules of Montana: ARM 37.106.1906 (checked October 15, 2026)
- ARM 37.106.1902 (mental health center definitions, incl. chemical dependency services), Administrative Rules of Montana: ARM 37.106.1902 (checked October 15, 2026)
- ARM 37.27.106 (state approved SUD programs, ASAM Criteria, biennial inspection), Administrative Rules of Montana: ARM 37.27.106 (checked October 15, 2026)
- DPHHS, Mental Health Center rules (incident file, history lines): Mental health center rules (PDF) (checked October 15, 2026)
- MCA 37-39-102 (Board of Behavioral Health): MCA 37-39-102 (checked October 15, 2026)
- MCA 37-39-307 (candidate license, training and supervision plan): MCA 37-39-307 (checked October 15, 2026)
- LAC rules, Administrative Rules of Montana: ARM 24.219.403 (exams), ARM 24.219.5006 (education) and ARM 24.219.5008 (supervised work) (checked October 15, 2026)
- MCA 2-15-1744 (Board of Behavioral Health allocated to the Department of Labor and Industry): MCA 2-15-1744 (checked October 15, 2026)
- 2025 SB 516 effective date (all sections October 1, 2025), Montana Legislature bill data: SB 516 session law effective dates (checked October 15, 2026)
- CMS, approved accrediting organizations: Accrediting Organizations (checked October 15, 2026)
- DEA Diversion Control Division, Dear Registrant letter, January 12, 2023: DEA letter (PDF) (checked October 15, 2026)
- CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 15, 2026)
- ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 15, 2026)
- CARF provider search: Find a Provider (checked October 15, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, Montana, SOC 21-1018: Montana OEWS and national estimates (checked October 15, 2026)