Mississippi Drug and Alcohol Outpatient Treatment Licensing

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.

Apply now: DMH Division of Certification (Interested Provider Portal and forms) | Questions: certification@dmh.ms.gov or 601-359-1288

Nine hours a week is the line that organizes outpatient addiction treatment in Mississippi. Under Rule 22.2 of the Operational Standards issued by the Mississippi Department of Mental Health (DMH), Level 1 outpatient services “must be less than nine (9) hours a week,” and Level 2.1 intensive outpatient for adults starts at “Group therapy for a minimum of nine (9) hours a week.” The rule then keeps the two apart physically. Level 1 has to be “in a physical space which is separate from other substance use services,” IOP must have its own separated space as well, and each space has to stay closed to other services during its hours of operation. Our reading is that a clinic offering standard counseling and an IOP should plan two rooms rather than trading one group room on alternating afternoons, and should get DMH’s view in writing before trying to time-share.

What DMH grants is certification, recorded on a Certificate of Operation, rather than a license, and DMH’s interested provider FAQ tells applicants they can offer services without being certified. The FAQ’s exception is about billing Medicaid, and DMH grant funding carries its own certification rule, both payer arrangements that sit outside these standards and outside the work we do. For a private-pay clinic, then, certification is a decision, and this guide covers what the decision commits you to.

Residential care and detox are in Mississippi Drug and Alcohol Inpatient Treatment Licensing. For mental health clinics, see Mississippi Mental Health Outpatient Licensing, and the Mississippi Behavioral Health Licensing page sets out every track.

Outpatient Levels Written Into Rule 22.2

Hours, labels and quotations in this section are taken from DMH’s Operational Standards PDF (effective November 1, 2024) as posted on dmh.ms.gov.

ASAM level in DMH rules	What it is	Weekly hours in the rule
0.5	Early Intervention	No weekly minimum stated in the sections we read
1	Outpatient Treatment	Less than 9 hours a week
2.1	Intensive Outpatient, adults	At least 9 hours of group therapy a week
2.5	Partial Hospitalization (Chapter 23)	Set in Chapter 23, not covered here
2-WM	Ambulatory withdrawal management (Chapter 50)	Not an hours-based level

Two other lines in Chapter 22 shape the schedule. Rule 22.1.F requires an outpatient psychotherapy provider to offer “a minimum of three (3) hours weekly” of services in evenings or on weekends, so a nine-to-five clinic doesn’t meet it. And DMH still works from the ASAM Criteria, 3rd Edition, under Provider Bulletin PR0146, which is the edition your placement criteria should cite. Chapter 49 layers on top of Chapter 22 for every certified SUD service, and one of its duties is a monthly MSAMIS data submission, which DMH expects within ten working days after the month closes.

Solo Offices and Group Practices

A licensed clinician seeing clients in a private office has nothing to certify with DMH. Rule 2.3.B limits certification to “agency providers/businesses registered and in good standing with the Mississippi Secretary of State, rather than licensed independent practitioners,” and Miss. Code 41-4-7(r) says people “already professionally licensed by another state board or agency are not required to be certified/licensed under this section by the Department of Mental Health.” The practitioner’s own board license governs the work. A group practice registered with the Secretary of State as a business can apply.

There is no facility license or Certificate of Need for an outpatient office either. MSDH’s hospital rules exclude “offices or clinics where patients are not regularly kept as bed patients,” and the CON statute leaves out facilities for the private practice of physicians and other health care professionals. In our reading, a Mississippi outpatient SUD clinic answers only to DMH, if it chooses certification, and to each clinician’s licensing board.

Buprenorphine and MAT Policies in a Mississippi Clinic

A certified clinic has to show, in writing, how it handles people on medication. Rule 49.1.B.6 requires a policy on “Acceptance and accommodation of people entering treatment services utilizing medication assisted treatment (MAT) or beginning the use of medication assisted treatment after admission to treatment services.” We found no rule in Chapters 22 or 49 obligating an outpatient clinic to prescribe MOUD itself, so for many clinics the policy describes referral to, and coordination with, a prescriber.

Buprenorphine prescribed in the office takes the least setup. The DATA-Waiver is gone, according to DEA’s registrant letter of January 12, 2023, and buprenorphine prescriptions “only require a standard DEA registration number.” The prescriber also needs a Mississippi controlled substance registration from their own board under Miss. Code 41-29-125. We read that section in 2026 House Bill 1267, a bill that died and so left that text unchanged. A clinic that dispenses controlled substances on site, rather than writing prescriptions, falls under the Board of Pharmacy’s monitoring program reporting duty. Clients on methadone get it from an opioid treatment program, which DMH certifies on its own track under Chapter 53. Note the OTP in the client’s record and keep a coordination agreement with it.

Running a Ketamine Clinic in Mississippi

Nothing in Mississippi’s statutes or rules that we read addresses ketamine clinics. The facility and ownership conclusions here are our interpretation. Prescribing, nursing and federal points come from the sources linked in each paragraph.

We found no facility license that applies to a physician practice giving ketamine for depression or PTSD. MSDH’s hospital definition excludes outpatient offices, the CON law excludes private practice settings, and DMH certifies neither independent practitioners nor ketamine as a service. What is regulated is the people and the drug: the prescribers’ licenses, their DEA and state registrations, the nursing roles, and the ownership structure.

Ownership Without a Clear Rule

Our research for this guide turned up no Mississippi statute, regulation or court decision on whether a non-physician may own a medical practice, and we did not review the state’s professional corporation or PLLC statutes. We can’t tell you Mississippi bars lay ownership, and we can’t tell you it allows it. Given that, we’d build conservatively: the practice owned by a Mississippi-licensed physician, and a separate management services organization that handles the lease, reception, billing and advertising for a flat fee unrelated to infusion volume. Clinical decisions, the medical records and every registration stay with the practice. Have Mississippi counsel confirm the entity choice before you file.

Nurse Practitioners and RNs

A nurse practitioner can’t open a ketamine clinic alone in Mississippi. The APRN statute, Miss. Code 73-15-20, quoted from 2026 House Bill 40 (which died, leaving the current text in place), bars APRN practice without “a collaborative/consultative relationship with a physician or dentist and a board-approved protocol or practice guidelines.” A certified nurse practitioner may prescribe Schedules II through V after a board-approved program, and every 2025 and 2026 bill to relax the collaboration rule died. Whether an APRN may hold an ownership share in the practice entity is something we did not confirm.

RN staffing is where Mississippi gets specific. The Mississippi Board of Nursing’s IV moderate sedation position statement (reviewed April 11, 2025) names ketamine as one of the anesthetic agents a registered nurse without anesthesia-provider qualifications may not give, and it also bars that nurse from procedural monitoring of a patient another professional dosed. The statement concerns sedation, and the board’s list of statements has no separate one on psychiatric ketamine. Our reading is that a clinic built around RN-run infusions is exposed in Mississippi until the board says otherwise, so plan on a physician or qualified anesthesia provider administering IV doses.

Registrations, the Monitoring Program and Spravato

Federal Schedule III status (21 CFR 1308.13(c)(7)) means each prescriber holds a DEA registration and a Mississippi registration from their own board. Mississippi’s monitoring law, Miss. Code 73-21-127 as enacted in 2025 House Bill 856, requires reporting from “any entity dispensing controlled substances in or into the State of Mississippi.” Administering is defined apart from dispensing in that act. Whether an in-office infusion counts as a reportable event is a point we couldn’t settle, so ask the Board of Pharmacy and keep its reply on file. A clinic offering Spravato enrolls in the SPRAVATO REMS, which certifies the healthcare settings that dispense the drug and states that “patients are required to be monitored by a healthcare provider for at least 2 hours.”

Many patients will come to the clinic partway through a series begun in residential care. The ketamine section of Mississippi Drug and Alcohol Inpatient Treatment Licensing deals with that starting point, the DMH reporting step for a certified house, and the federal referral payment law that applies between the two.

Staffing a Certified Outpatient Program

Rule 11.4.A requires one full-time Executive Director with a graduate degree and three years of administrative experience, or a bachelor’s degree and seven. Rule 11.6.A asks the SUD program’s director for two years of substance use experience plus a professional license or one of DMH’s therapist credentials. Therapy is delivered by holders of a professional license (the glossary’s examples include the LPC, P-LPC and licensed psychologist, and the rules also list social workers, marriage and family therapists and physicians) or a DMH Mental Health or Addictions Therapist credential. Prescribing in a clinic falls under Rule 11.4.D: a board-certified or board-eligible psychiatrist, a PMHNP, or a different licensed medical professional whose scope covers it.

In Mississippi, the BLS category covering substance abuse, behavioral disorder, and mental health counselors has a median wage of $46,990 (OEWS, May 2025). The 25th percentile is $38,760, the 75th is $58,560, and the national median of $59,350 sits above all three. A clinical director and three counselors at the state median cost about $187,960 a year before benefits (4 x $46,990, our estimate), and the full-time Executive Director the rule requires is a separate line. Few Mississippi clinics fill every counseling slot with a fully licensed clinician on opening day, and the state’s provisional licenses are built for exactly that situation. To move from P-LPC to LPC, the counselor board’s rule (30 Miss. Code R. 2201-4.3) calls for 3,000 hours of supervised post-master’s counseling across 18 months or longer, with direct client work accounting for at least 1,200, and DMH already accepts the P-LPC for delivering therapy in a certified program. The DMH PLACE Substance Use Therapist track offers a provisional PCSUT with no experience requirement and a full CSUT after 24 months of supervised full-time work, but PLACE ties its credentials to employment in the state mental health system, so confirm with PLACE before counting on it. Paying provisional counselors below the licensed scale while a licensed clinical director supervises their hours generally saves 40 to 60 percent of counseling payroll against an all-licensed team. A clinic that adds in-house medication services can put one RN over several LPNs. How many groups you run each week sets the real headcount.

Where Accreditation Helps

An outpatient clinic accredited by The Joint Commission, and not funded by DMH, must include documentation of that accreditation with its application under Rule 49.1.D, and DMH decides if it is enough to support certification in the matching SUD service areas. It doesn’t replace the DMH review, it isn’t deemed status, and the rule doesn’t mention CARF or COA. We found no accreditation benefit at renewal.

How to Submit Your DMH Outpatient Certification Application

New agencies start in the Interested Provider Portal, linked as “Become a Certified Provider” on the Division of Certification page. Complete the online orientation, then upload the agency packet listed on the application checklist. When DMH sends its notice, pay the $150 nonrefundable application fee through the payment portal within 30 business days. Once the agency is approved, each site goes in on an Application to Add a New Program, followed by the initial Health and Safety inspection and the $300 Initial Certification fee. An agency that is already certified and wants to add IOP to its existing outpatient services would, in our reading, file the Application to Add a New Service from the same page, so confirm the right form with the Division first.

Renewal is $300 per certification period, and the full cycle runs four years with a December 31 deadline. DMH’s FAQ says certification can take up to a year from start to full status. For an outpatient clinic we plan on 9 to 12 months (our estimate), a figure driven by the review rounds (30 business days for DMH’s first notice, 30 business days for each set of revisions) and by the site inspection, which is where a shared Level 1 and IOP room would show up. Write to certification@dmh.ms.gov or call 601-359-1288, and the Technical Assistance Form is the formal way to request help.

Outpatient Mistakes We Expect to See

An IOP calendar that adds up to eight and a half hours of group in a holiday week is the classic one, because 2.1 is defined by its nine-hour group minimum. A floor plan that puts Level 1 and IOP in the same space is another. Clinics also forget the evening and weekend hours in Rule 22.1.F, and operators coming from other states cite the ASAM Fourth Edition in policies DMH still reads against the Third.

Frequently Asked Questions

Laying out an IOP schedule that clears the nine-hour line? Ask us.

Sources

• Mississippi DMH: Division of Certification (checked October 18, 2026)
• Mississippi DMH, Operational Standards for MH, IDD and Substance Use Community Service Providers (effective November 1, 2024): Operational Standards (PDF) (checked October 18, 2026)
• Mississippi DMH: Interested Provider Orientation FAQs (PDF) (checked October 18, 2026)
• Mississippi DMH: Interested Provider Application Checklist (PDF) (checked October 18, 2026)
• Mississippi DMH: Application to Add a New Program, 2024 (PDF) (checked October 18, 2026)
• Mississippi DMH: Division of Certification online payment portal (checked October 18, 2026)
• Mississippi DMH: Technical Assistance Form (PDF) (checked October 18, 2026)
• Mississippi DMH, Provider Bulletin PR0146 (November 28, 2023): ASAM Criteria edition (PDF) (checked October 18, 2026)
• Mississippi Legislature, Miss. Code 41-4-7 as brought forward in 2026 SB 2478: SB 2478, As Passed the Senate (checked October 18, 2026)
• MSDH: Health Facilities Licensure and Certification (checked October 18, 2026)
• MSDH, Title 15 Part 16 Subpart 1, Chapter 41: Minimum Standards of Operation for Mississippi Hospitals (PDF) (checked October 18, 2026)
• MSDH: Certificate of Need (checked October 18, 2026)
• Mississippi Legislature, 2026 HB 3 (Chapter 301), Miss. Code 41-7-173 and 41-7-191: HB 3, As Sent to Governor (checked October 18, 2026)
• DEA Diversion Control Division: Dear Registrant letter, January 12, 2023 (PDF) (checked October 18, 2026)
• Mississippi Legislature, Miss. Code 41-29-125 as reproduced in 2026 HB 1267 (died): HB 1267, As Introduced (checked October 18, 2026)
• Mississippi Legislature, 2025 HB 856 (Chapter 509), Miss. Code 73-21-73 and 73-21-127: HB 856, As Sent to Governor (checked October 18, 2026)
• Mississippi Legislature, Miss. Code 73-15-20 as reproduced in 2026 HB 40 (died): HB 40, As Introduced (checked October 18, 2026)
• Mississippi Legislature: 2026 bills affecting Miss. Code 73-15-20 (checked October 18, 2026)
• Mississippi Board of Nursing: Position statement, Administration and Management of IV Moderate Sedation, reviewed April 11, 2025 (PDF) (checked October 18, 2026)
• Mississippi Board of Nursing: Position statements (checked October 18, 2026)
• 21 CFR 1308.13(c)(7), via Cornell LII: Schedule III, ketamine (checked October 18, 2026)
• Janssen, SPRAVATO REMS: SPRAVATO REMS (checked October 18, 2026)
• Mississippi DMH: Division of Professional Licensure and Certification (PLACE) (checked October 18, 2026)
• Mississippi DMH, PLACE: Professional Credentialing Rules and Requirements, effective July 28, 2026 (PDF) (checked October 18, 2026)
• Board of Examiners for Licensed Professional Counselors, 30 Miss. Code R. 2201-4.3, via Cornell LII: LPC licensure requirements (checked October 18, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: Mississippi estimates (checked October 18, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: National estimates (checked October 18, 2026)