If you run, finance or are about to launch an addiction or mental health program in Wisconsin, this overview is aimed at you, and especially at operators used to states where the approval is called a license rather than a certificate.
Additional Wisconsin Licensing Guides
- Wisconsin Drug and Alcohol Inpatient Treatment Licensing
- Wisconsin Drug and Alcohol Outpatient Treatment Licensing
- Wisconsin Mental Health Inpatient Licensing
- Wisconsin Mental Health Outpatient Licensing
- Wisconsin License Reinstatement
One Division, and the Word Is Certification
The facts in this section come from the Department of Health Services’ own program pages and the rule chapters they cite.
Operators arriving from other states tend to ask which Wisconsin agency licenses rehab programs. The honest answer is that none of them does, at least not by that name. The Department of Health Services (DHS), Division of Quality Assurance (DQA) certifies substance use treatment under chapter DHS 75 and certifies outpatient mental health clinics under chapter DHS 35, along with adult inpatient mental health programs under DHS 61.71. Initial applications, service additions, branch offices, ownership changes and the recurring paperwork all go through one online system, the DQA Provider Portal, and one email box answers questions for both tracks. Hospitals, psychiatric hospitals included, sit in the same department but on a different statute: DHS issues them a certificate of approval under Wis. Stat. 50.35.
Two features of that system matter more than the vocabulary. First, a certificate doesn’t run out. DQA Memo 24-001, dated January 18, 2024, says certificates under DHS 34, 35, 36, 61, 63 and 75 are issued “with no expiration date,” so what keeps one alive is a biennial report, a biennial fee and a biennial on-site survey. Second, accreditation buys a hospital something and a community program nothing we could find. Section 50.36(3L) exempts a hospital accredited by a Medicare-approved accreditor from routine state inspections, while the DHS 75 and DHS 35 sections we read contain no deemed status or survey waiver at all. CARF or Joint Commission accreditation still has value for a Wisconsin SUD or clinic operator, but it sits next to the DQA survey cycle and does not replace it.
What Is Changing in 2026
Each date below comes from the rule order, act or agency page linked in Sources. Where a rule is still pending we say so.
Counselor credentialing changed first. The Department of Safety and Professional Services rewrote chapters SPS 160 to 168 in clearinghouse rule CR 25-095, published in the May 2026 Register and effective June 1, 2026. The adopted order resets the experience hours behind each tier: a substance abuse counselor now documents 3,000 hours of work experience, at least 1,500 of them counseling and at least 500 of those one-on-one, and continuing education is 30 hours per two-year credential period.
Nurse practitioners come next. 2025 Wisconsin Act 17 was enacted August 8, 2025, and DSPS says it took effect September 1, 2026, converting APNP licenses to APRN licenses that day. Under Wis. Stat. 441.09(3m), an APRN may practice independently after the Board of Nursing confirms 3,840 hours of professional nursing in a clinical setting, 3,840 clinical hours of advanced practice nursing and the two 24-month conditions in that subsection.
The SUD rule itself is in motion but not finished. Clearinghouse rule CR 25-054, the clearinghouse rule revising DHS 75, has been with the Legislature since March 2026. The Assembly health committee got it on March 13 and the Senate health committee on March 25, each asked for a meeting with the agency in April, and the history shows nothing after April 22. EmR2511, the emergency version, is listed by the Legislature as expired. A second and wider DHS 75 project, scope statement SS 017-26, won the Governor’s approval on March 18, 2026 and had its preliminary hearing April 28. Until one of them is published with an effective date, our reading is that operators answer to the chapter as recreated in 2022 and amended by CR 23-067 in May 2025. Keep an eye on the DHS administrative rules page for the day that changes.
Primary Regulatory Agencies
Agency roles below follow the wording on each agency’s own pages.
- Wisconsin Department of Health Services, Division of Quality Assurance, whose Behavioral Health Certification Section certifies substance use treatment programs (DHS 75) and mental health programs such as outpatient clinics (DHS 35) and adult inpatient programs (DHS 61.71), and which also licenses community-based residential facilities under DHS 83
- Department of Health Services hospital approval under Wis. Stat. 50.33 to 50.36 and chapter DHS 124, which covers psychiatric hospitals and hospital psychiatric units
- Department of Safety and Professional Services (DSPS), which issues substance abuse counselor credentials under Wis. Stat. 440.88 and houses the Board of Nursing
Wisconsin Behavioral Health Licensing Snapshot
Nothing in this table goes beyond the rule or statute cited on its row.
| Primary SUD Regulator | DHS Division of Quality Assurance, certification under ch. DHS 75 |
| Mental Health Facility Licensing | DQA certifies outpatient clinics (DHS 35) and adult inpatient programs (DHS 61.71). DHS approves hospitals (s. 50.35, ch. DHS 124). Adult residential mental health settings are generally licensed as CBRFs under DHS 83, which is our reading |
| Residential Treatment | Certified by service level under DHS 75: transitional residential (75.53), medically monitored residential (75.54) and adult residential integrated behavioral health stabilization (75.56) |
| Outpatient Treatment | Outpatient under 9 hours a week (75.49), intensive outpatient at 9 or more (75.51), day treatment or partial hospitalization at 15 or more (75.52), for adults |
| Withdrawal Management | Residential withdrawal management (75.57), plus medically managed inpatient treatment in a hospital setting (75.55) |
| Facility License Required | Yes. DHS approval must be secured before treatment is rendered (s. 51.45(8)(c)). DHS 35 clinic certification applies to clinics seeking reimbursement (DHS 35.02) |
| Certificate of Need | None for behavioral health. The ch. 150 approval program covers nursing homes, and the psychiatric and chemical dependency bed limit applied only before July 1, 1996 |
| National Accreditation | No deemed status found for DHS 75 or DHS 35 programs. Accredited hospitals skip routine state inspections under s. 50.36(3L) |
| Inspection | Biennial on-site surveys (Memo 24-001), plus announced and unannounced inspections (DHS 75.09) |
| Renewal | No expiration date. Biennial forms and continuation fee every 24 months (DHS 75.06) |
| Decision Clock | 60 days after a complete application (DHS 75.05, DHS 35.08) |
| Key Regulations | Wis. Stat. 51.04, 51.45(8), 51.64, 50.33 to 50.36 and ch. 150. Wis. Admin. Code chs. DHS 75, DHS 35, DHS 83 and DHS 124, DHS 61.71, and chs. SPS 160 to 168 |
Which Wisconsin Rules Reach Which Program
We built this grid ourselves from the rule chapters, since DHS keeps each chapter on its own page.
| Program | What you apply for | Who issues it | Accreditation effect |
|---|---|---|---|
| Residential SUD treatment | DHS 75 certification for each residential service level | DQA, through the Provider Portal | None found |
| Residential withdrawal management | DHS 75.57 certification | DQA | None found |
| Outpatient SUD, IOP, day treatment | DHS 75.49, 75.51 or 75.52 certification | DQA | None found |
| Outpatient mental health clinic | DHS 35 certification, which covers additional offices without separate certificates | DQA | None found |
| Adult residential mental health home | CBRF license under DHS 83 (our reading of the path) | DQA, with an initial onsite visit | None found |
| Psychiatric hospital or unit | Hospital certificate of approval, and DHS 61.71 inpatient program certification where it applies | DHS | Accredited hospitals are exempt from routine state inspections |
Wisconsin’s SUD rule names its levels by weekly treatment hours and setting, not by ASAM number, yet DHS 75.23 tells programs to “utilize ASAM placement criteria” when placing patients. That gap is where CARF’s ASAM Level of Care Certification earns a look. CARF offers it for adult residential Levels 3.1, 3.5 and 3.7, and ASAM’s certification page names CARF as its delivery partner. Hospitals and referral coordinators who want proof of a level can tick “ASAM Level of Care 3.7” (3.1 and 3.5 sit beside it) under Certification in CARF’s provider search, something a DQA certificate for medically monitored residential cannot show them. Pairing a DHS 75 service with an ASAM number is our interpretation. Neither page names a withdrawal management level, and we would not market a 75.57 service as CARF level-certified.
Programs Covered
- Residential substance use treatment, from transitional residential through medically monitored residential
- Residential withdrawal management
- Outpatient, intensive outpatient and day treatment for substance use disorders
- Outpatient mental health clinics
- Adult inpatient mental health programs and psychiatric hospitals
- Residential settings for adults with mental health needs
Key Licensing Requirements
Every item traces to DHS 75, DHS 35 or DQA’s portal instructions.
- A MyWisconsin ID and an application filed in the DQA Provider Portal, with the service policies and procedures the chapter requires
- For residential SUD services, a floor plan, a 24-hour staffing pattern, evacuation and disaster plans, municipal zoning approval or an occupancy permit, inspection results from the past 12 months and 60 days of projected operating funds in reserve (DHS 75.29)
- A service director, a clinical supervisor and a substance abuse counselor on hand during clinical hours (DHS 75.18), plus medical director oversight at the intensive outpatient, day treatment and medically monitored residential levels, among others
- A clinic administrator and one of the three professional staffing combinations in DHS 35.123 for an outpatient mental health clinic
- A finding that the applicant is fit and qualified, which looks at compliance history, arrest and criminal records and money owed to DHS
- Biennial forms and the certification continuation fee every 24 months after approval
Frequently Asked Questions
What does it cost to get certified in Wisconsin?
The state fee is the smallest line, and DHS has not published a current amount we could verify. Wis. Stat. 51.04 directs DHS to charge a fee for each certification, and DHS 75.06 collects a certification continuation fee every 24 months, so ask DQA for the figure that applies to your service mix before you budget. Residential SUD applicants face a bigger number up front: DHS 75.29 asks for proof of 60 days of projected operating funds in reserve. A residential mental health home licensed as a CBRF pays $389 plus $50.25 per resident of licensed capacity every two years, which for a 16-bed home works out to $1,193. Wages and rent will matter far more than any of these line items.
How long does Wisconsin certification take?
DHS has 60 days to approve or deny once an application is complete, under both DHS 75.05 and DHS 35.08. The clock only starts when DQA considers the file complete, and writing policies to every DHS 75 or DHS 35 section takes longer than the review itself. Our planning estimate is 3 to 5 months for an outpatient SUD program or mental health clinic and 6 to 9 months for residential, where zoning approval, fire and building inspections and the 24-hour staffing plan have to be ready before filing. A CBRF runs on a separate 70-day decision period after its application is complete. Both ranges are our own planning figures, and Wisconsin sets no such deadline.
What trips up Wisconsin applicants most often?
Reading old guidance. Pages that still talk about Type I and Type II residential programs, annual renewals or one-year provisional certificates describe rules DHS retired when the current DHS 75 took effect October 1, 2022, and when Memo 24-001 removed expiration dates. The second is assuming CARF or Joint Commission accreditation will shorten the DQA survey. We found no provision that does that for community programs. The third is the appeal window. A DHS 75 program has only 10 days to appeal an enforcement notice, while a DHS 35 clinic has 30, and owners who run both tend to remember the longer one.
Can you guarantee a Wisconsin certificate?
No. The decision belongs to DQA, which must turn down an applicant that falls short of substantial compliance, fails the fit-and-qualified review or carries an unpaid balance with the department (DHS 75.05). What we control is the file itself: policies matched to the DHS 75 or DHS 35 text in force today rather than the pending rewrite, and every service level the program will deliver listed on the application.
How much staff will I need to open a program in Wisconsin?
DHS 75.18 sets the core for a substance use program: a service director readily available whenever the service runs, a clinical supervisor on staff or under contract, and a substance abuse counselor available during clinical hours, and the rule text for intensive outpatient, day treatment and medically monitored residential each places the service under a medical director’s oversight. Wisconsin counselors in the BLS substance abuse, behavioral disorder and mental health category earn a median of $62,220, against $59,350 nationally, and the state’s 25th and 75th percentiles sit at $52,420 and $77,520 (BLS OEWS, May 2025). Six clinical salaries at that median, enough for a director, a supervisor and four counselors, total about $373,000 a year by our arithmetic, with benefits on top. Wisconsin’s counselor-in-training credential means that figure is a ceiling, not the plan. A substance abuse counselor-in-training needs 100 hours of specialized education and a job, internship or practicum at an SUD treatment agency, then practices under a DSPS-approved clinical supervisor while building toward the 3,000 hours the full SAC requires, so a clinical supervisor overseeing several trainees at lower wages commonly trims clinical payroll by 40 to 60 percent compared with an all-credentialed counseling team, and residential programs that need nursing can schedule one RN over several LPNs instead of RNs on every shift. Send us your planned levels and bed or caseload count and we will turn this into a position-by-position budget.
Licensing
Is a Wisconsin certificate the same thing as a license?
For practical purposes it does the same job. Section 51.45(8)(c) says approval must be secured “before treatment in any facility is rendered to patients,” and DHS 75.23(1)(b) bars a program from offering a service its certificate does not include. The terms differ elsewhere: a CBRF holds a license under DHS 83 and a hospital holds a certificate of approval under s. 50.35.
Does my outpatient mental health practice need DHS 35 certification?
DHS 35.02 applies the chapter to outpatient clinics that request reimbursement from Medical Assistance, from insurers under s. 632.89, or from public funds. Our reading is that a practice billing none of those falls outside DHS 35 and runs on its clinicians’ own licenses. A clinic that bills them needs the certificate. That funding link is the trigger, and the funding relationships themselves sit outside licensing and outside what we handle. More detail is in Wisconsin Mental Health Outpatient Licensing.
Does accreditation help with DQA certification?
Not in any rule we found. We went through the DHS 75 sections on applications, approval, biennial filings, inspections, waivers and residential applicants, and the DHS 35 sections on certification, enforcement and waivers. None offers deemed status, gives credit for accreditation or waives a survey. The exemption in s. 50.36(3L) covers only hospitals holding accreditation from a Medicare-approved body under 42 USC 1395bb, and even then DHS keeps the power to inspect on a complaint.
Facility
Is there a Certificate of Need for behavioral health in Wisconsin?
No. The approval program in chapter 150 lists new nursing homes, nursing home capital spending over $1,000,000 and similar projects. Section 150.95 did freeze new psychiatric and chemical dependency beds, yet each prohibition in it opens with “Before July 1, 1996,” and we treat it as spent.
Where does an adult residential mental health program fit?
Not under a mental health certificate, because DQA doesn’t offer one for adult residential treatment. The license that fits most of these homes is the community-based residential facility, which DHS says can serve unrelated adults with mental health needs or substance use, five or more at a time, and can provide as much as three hours of nursing care per person per week. We treat the CBRF license as the usual path, covered in Wisconsin Mental Health Inpatient Licensing.
Do I need a new certificate for a second office?
It depends on the chapter. DHS 35.08 says additional offices of a mental health clinic “do not require separate certification.” On the SUD side, the DQA page lists branch additions as their own portal transaction, and the 2022 DHS conversion webinar said a new branch owed either a full or a half fee, depending on where it fell in the provider’s biennial cycle.
Staffing
What changed for Wisconsin addiction counselors on June 1, 2026?
CR 25-095 rewrote SPS 160 to 168. A counselor-in-training still needs 100 hours of specialized education. A substance abuse counselor needs 3,000 hours of work experience with at least 1,500 in SUD counseling, and a clinical substance abuse counselor needs 5,000 with at least 2,500. Continuing education under SPS 168.01 is 30 hours per two-year period, so the 40-hour figure still printed on one DSPS page should not drive your training budget.
Can social workers treat substance use disorders in a DHS 75 program?
Yes. Rule CR 23-067, which took effect May 1, 2025 and carries out 2021 Wisconsin Act 222, lets advanced practice and independent social workers treat SUD as a specialty.
Operations
What does Wisconsin require on medication for opioid use disorder?
When a patient seeks help for opioid use, a DHS 75 program that does not offer medication-assisted treatment must explain the benefits of medication, obtain written consent for treatment without it, and refer to a program that offers it (DHS 75.24(9)(b)). Every site and branch keeps naloxone on hand. Opioid treatment programs are certified separately, so a program without one coordinates with a certified OTP. The D&A guides cover the detail.
Which deaths and incidents must be reported?
Deaths a program believes are related to physical restraint, psychotropic medication or suicide go to DHS within 24 hours (DHS 75.10, s. 51.64), using the online F-62470 death report. A death from an incident or accident at the service location goes in within 3 working days, and abuse, neglect or misappropriation that the program’s investigation substantiates goes in within 7 calendar days.
How do I reach DQA?
DQA’s introduction page gives one phone line, 608-261-0656, and one mailbox, dhsdqamentalhealthandsubstanceusecertification@dhs.wisconsin.gov, for substance use and mental health certification alike. Anything about an application already in the portal belongs in the Provider Portal Communication Center.
Enforcement
What happens after a DQA survey finds problems?
A DHS 75 program gets a statement of deficiency and owes a plan of correction within 10 business days, or sooner if patient harm is possible, and failing to submit an approved plan is itself grounds for denial, suspension or revocation (DHS 75.09(2)). A DHS 35 clinic gets 30 days for its plan (DHS 35.11). We found no fines in either chapter.
How do appeals and reinstatement work?
A written appeal goes to the Department of Administration’s hearings division, within 10 days for DHS 75 and 30 days for DHS 35, and a timely appeal generally stays the action unless DHS finds an immediate risk or has summarily suspended a clinic. Because certificates no longer expire, losing one usually means a missed biennial report or fee, or an enforcement action. We walk through both routes in Wisconsin License Reinstatement.
What’s Included and What Isn’t
What we help with in Wisconsin
Picking the DHS 75 service levels a program actually needs, writing policies to the rule in force while CR 25-054 is pending, preparing residential files under DHS 75.29, DHS 35 clinic certification, and getting a program ready for CARF or Joint Commission accreditation for its own sake.
What falls outside that scope
We stay out of Medicaid, Medicare and CMS enrollment, billing and payer contracting, and we don’t sell marketing. Ask, and we’ll name firms that handle those.
Not sure whether your Wisconsin program belongs under DHS 75, DHS 35 or both? Ask 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
- Wisconsin DHS, Substance Use Treatment Programs: Certification: Substance use treatment certification (checked October 12, 2026)
- Wisconsin DHS, Mental Health Program Certification: Mental health certification (checked October 12, 2026)
- Wisconsin DHS, Substance Use Program Introduction (contacts): Introduction and contacts (checked October 12, 2026)
- Wisconsin DHS, DQA Provider Portal: DQA Provider Portal (checked October 12, 2026)
- Wisconsin DHS, DQA Memo 24-001 (January 18, 2024): Non-expiring certificates and biennial reports (PDF) (checked October 12, 2026)
- Wisconsin DHS, Administrative Rules page (CR 25-054, SS 017-26 status): DHS administrative rules (checked October 12, 2026)
- Wisconsin Legislature, CR 25-054 history: Clearinghouse Rule 25-054 (checked October 12, 2026)
- Wisconsin Legislature, expired emergency rules (EmR2511): Expired emergency rules (checked October 12, 2026)
- Wis. Admin. Code ch. DHS 75: Community Substance Use Service Standards (checked October 12, 2026)
- Wis. Admin. Code DHS 75.05, via Cornell LII: Approval and denial (checked October 12, 2026)
- Wis. Admin. Code DHS 75.06, via Cornell LII: Biennial forms and fees (checked October 12, 2026)
- Wis. Admin. Code DHS 75.09, via Cornell LII: Inspections, deficiencies and appeals (checked October 12, 2026)
- Wis. Admin. Code DHS 75.10, via Cornell LII: Reporting deaths and incidents (checked October 12, 2026)
- Wis. Admin. Code DHS 75.18, via Cornell LII: Staffing (checked October 12, 2026)
- Wis. Admin. Code DHS 75.23 and 75.24, via Cornell LII: Placement and treatment requirements (checked October 12, 2026)
- Wis. Admin. Code DHS 75.29, via Cornell LII: Residential application requirements (checked October 12, 2026)
- Wis. Admin. Code DHS 75.30, via Cornell LII: Fit and qualified standards (checked October 12, 2026)
- Wis. Admin. Code ch. DHS 35: Outpatient Mental Health Clinics (checked October 12, 2026)
- Wis. Admin. Code DHS 35.11, via Cornell LII: Enforcement and appeal (checked October 12, 2026)
- Wis. Admin. Code DHS 35.123, via Cornell LII: Minimum staffing (checked October 12, 2026)
- Wis. Stat. 51.04: Treatment facility certification (checked October 12, 2026)
- Wis. Stat. 51.45(8): Approval of treatment facilities (checked October 12, 2026)
- Wis. Stat. 51.64: Reports of death (checked October 12, 2026)
- Wis. Stat. 50.33 to 50.36: Hospital approval and accreditation exemption (checked October 12, 2026)
- Wis. Stat. ch. 150: Health care planning and regulation (PDF) (checked October 12, 2026)
- Wisconsin DHS, Community-Based Residential Facilities guide: CBRFs (checked October 12, 2026)
- Wisconsin DHS, Opening a CBRF: CBRF licensing and fee (checked October 12, 2026)
- Wisconsin DHS, Reporting a death: Death reporting procedure and F-62470 (checked October 12, 2026)
- DSPS, adopted order CR 25-095 (SPS 160 to 168): Substance use disorder counseling rule (PDF) (checked October 12, 2026)
- Wis. Admin. Code SPS 160.02 history note (CR 25-095, eff. June 1, 2026): SPS 160.02 (checked October 12, 2026)
- DSPS, Substance Abuse Counselor-in-Training: SAC-IT credential (checked October 12, 2026)
- DSPS, Board of Nursing: Board of Nursing (checked October 12, 2026)
- DSPS, FAQs on APRN implementation: APRN implementation FAQs (checked October 12, 2026)
- 2025 Wisconsin Act 17: 2025 Act 17 (checked October 12, 2026)
- Wis. Stat. 441.09: APRN licensure and independent practice (checked October 12, 2026)
- Wisconsin DHS, DHS 75 Act 222 rule order (CR 23-067): Act 222 rule order (PDF) (checked October 12, 2026)
- Wisconsin Legislature, CR 23-067: Clearinghouse Rule 23-067 (checked October 12, 2026)
- Wisconsin DHS, 2022 certification conversion webinar: Conversion webinar (PDF) (checked October 12, 2026)
- CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 12, 2026)
- CARF provider search: Find a Provider (checked October 12, 2026)
- ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 12, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: OEWS tables (checked October 12, 2026)