Written for people who run, or plan to run, a Maine program treating addiction or mental illness, whether the job in front of you is a first license, a second site, a sale or simply staying in good standing.
Additional Maine Licensing Guides
- Maine Drug and Alcohol Inpatient Treatment Licensing
- Maine Drug and Alcohol Outpatient Treatment Licensing
- Maine Mental Health Inpatient Licensing
- Maine Mental Health Outpatient Licensing
- Maine License Reinstatement
Maine Licenses Mental Health and SUD Programs Under a Single Rule
Dates and rule names in this section come from the DHHS rulemaking record and the rule text itself. The note on separate licenses quotes DLC’s Behavioral Health Program page.
Most states make an operator learn two rulebooks, one for addiction treatment and another for mental health. Maine folded them together. The Behavioral Health Organizations Licensing Rule, 10-144 CMR Ch. 123, took effect February 11, 2024, and it repealed three older chapters at once: the substance use disorder rule (14-118 CMR Ch. 5) and the two mental health rules (14-193 CMR Ch. 6 and Ch. 6-A). DHHS described the goal on its rulemaking page as “a comprehensive, one-stop licensing rule.” The rule’s own purpose statement says it “consolidates requirements for the licensing of mental health and substance use disorder programs.”
The paperwork has not caught up with the rule. Ch. 123 prices three categories, mental health only, SUD only and integrated, and §3 even sets a combined fee for “both service categories or integrated services.” Yet DLC’s own Behavioral Health Program page says today that licenses “are not currently integrated” and that a provider offering both kinds of care must “submit separate applications” and “hold separate licenses for each agency type.” So one rulebook governs both sides, but an organization treating addiction and mental illness still files two applications and holds two licenses, each listing its own service types, modules and sites. Plan your budget and timeline around two files until DLC announces otherwise.
Two later changes sit on top of the 2024 rule. Public Law 2025, chapter 305 (LD 1961), signed June 12, 2025 and in effect since September 24, 2025, changed the statute so the Department monitors licensed agencies “at least once every 2 years” instead of every year. And chapter 599 of the 2025 Public Laws lifted one of the Certificate of Need dollar triggers, which matters only to hospital projects, a point we come back to below.
Primary Regulatory Agencies
Each role is described here the way the agency’s own web page or the governing statute puts it.
- Maine Department of Health and Human Services (DHHS), Division of Licensing and Certification (DLC), Behavioral Health Program, which licenses mental health and substance use disorder programs under 10-144 CMR Ch. 123, currently as two separate agency licenses
- DLC Medical Facilities Unit, which licenses hospitals, psychiatric hospitals included, under 10-144 CMR Ch. 112, and the DLC Certificate of Need program
- DHHS Office of Behavioral Health (OBH), formerly the Office of Substance Abuse and Mental Health Services, which does not issue facility licenses but receives certain notices and incident forms under Ch. 123
- State Board of Alcohol and Drug Counselors (listed on its web page as the Board of Alcohol & Drug Counselors), which credentials addiction counselors under 32 MRS ch. 81
Maine Behavioral Health Licensing Snapshot
A plain summary of the rule sections and statutes cited in each row.
| Primary SUD Regulator | DLC Behavioral Health Program, SUD agency license under 10-144 CMR Ch. 123 |
| Mental Health Facility Licensing | DLC Behavioral Health Program, a mental health agency license under the same rule but on its own application. DLC says licenses are not currently integrated, so a provider doing both holds two. Psychiatric hospitals hold a DLC hospital license under Ch. 112 |
| Residential Treatment | Residential modules on the SUD license (residential treatment, medically supervised withdrawal) or the mental health license (residential with or without secure capacity, crisis stabilization residential) |
| Outpatient Treatment | Outpatient modules on the SUD or mental health license, including intensive outpatient (SUD IOP runs at least 3 days a week, 3 hours a day) |
| Withdrawal Management | Listed both as an outpatient SUD service and as residential medically supervised withdrawal |
| Facility License Required | Yes for behavioral health organizations. Solo clinicians have no written carve-out, so confirm with DLC |
| License Path | Provisional license of 3 to 12 months for a new organization, then a full license for 2 years |
| Certificate of Need | Limited to hospitals and other listed health care facilities, psychiatric hospitals included. Ch. 123 organizations are not on the list |
| National Accreditation | Deemed status in statute and rule for fully licensed organizations accredited by The Joint Commission, CARF or COA, covering specific rule provisions |
| Inspection | State monitoring at least once every 2 years since September 24, 2025, plus State Fire Marshal certification of each site before initial licensing and re-licensing (§2(N)) |
| Fees | Rule schedule: provisional $125 (one category) or $250 (both or integrated). Full $250 or $500. Biennial renewal $170 or $340. Ask DLC how the combined tier applies while it issues separate licenses |
| Key Regulations | 10-144 CMR Ch. 123, 34-B MRS §1203-A, §3601 and §3603 (mental health authority DLC cites), 5 MRS §20005(6) and §20024, 22 MRS §42(1) and §8002, 22-A MRS §205(2) (SUD authority DLC cites), 22 MRS ch. 1667, 22 MRS ch. 405 and 10-144 CMR Ch. 112 (hospitals), 22 MRS ch. 103-A (CON), 22 MRS ch. 1684 (hospital sentinel events) |
Maine Programs by License, Unit and CON Exposure
Our layout of the rules. DHHS does not publish a side-by-side like this one.
| Program | License and rule | DLC unit | Certificate of Need |
|---|---|---|---|
| Residential SUD treatment or medically supervised withdrawal | SUD agency license, Ch. 123 §23 | Behavioral Health Program | No |
| Outpatient SUD, IOP, MOUD | SUD agency license, Ch. 123 §23 | Behavioral Health Program | No |
| Mental health residential, including secure capacity and crisis stabilization | Mental health agency license, Ch. 123 §22 | Behavioral Health Program | No |
| Outpatient mental health therapy and assessment | Mental health agency license, Ch. 123 §22 | Behavioral Health Program | No |
| Co-occurring (integrated) programs | Program standards in Ch. 123 §24 and an integrated fee tier in §3, but DLC currently issues a separate mental health license and SUD license on separate applications | Behavioral Health Program | No |
| Psychiatric hospital | Hospital license, 10-144 CMR Ch. 112 | Medical Facilities Unit | Yes, when a §329 trigger applies |
Maine’s SUD programs must place clients using The ASAM Criteria (Ch. 123 §23(A)(1)), yet the license itself names services such as residential treatment and medically supervised withdrawal, never a level number. An operator who wants a residential level verified by someone outside DLC can look at CARF’s ASAM Level of Care Certification, the only program ASAM has approved for this, which certifies Levels 3.1, 3.5 and 3.7 for adults in residential care. It will not show up on a Maine license. Referral partners can still confirm it in CARF’s provider search by choosing the certification filter labeled “ASAM Level of Care 3.7”, and there are matching filters for 3.1 and 3.5. Since neither CARF nor ASAM lists withdrawal management among the certified levels, our reading is that it fits a residential treatment module and not medically supervised withdrawal.
Programs Covered
- Residential substance use disorder treatment and medically supervised withdrawal
- Outpatient and intensive outpatient SUD treatment
- Outpatient mental health therapy, assessment and intensive outpatient services
- Mental health residential treatment, including secure capacity and crisis stabilization units
- Co-occurring mental health and substance use disorder programs, which today run on two DLC licenses
- Psychiatric hospitals
Key Licensing Requirements
Drawn from Ch. 123 §§2, 3 and 21 and the DLC Behavioral Health Program page.
- A DLC application for each agency type you will run (the mental health form, the SUD form, or both filed separately), emailed with supporting documents to BehavioralHealth.DLC@maine.gov, with the fee mailed by check to “Treasurer, State of Maine”
- An organizational chart, staff roster, sample client file, policy attestation, emergency plans, local code documentation, and a plan for winding the business down, with a bond or comparable security set aside to pay for it
- State Fire Marshal certification of every site under §2(N), written life safety documentation after an SFMO inspection for residential facilities under §21(E)(11)(a), and no private residences as treatment sites
- For residential services, a notice letter sent to each of two DHHS offices, MaineCare Services and OBH, before you apply
- A 30-day notice and DLC approval before adding a module, and 90 days before adding a site
Frequently Asked Questions
What does a Maine behavioral health license cost?
The state fees are small. Under Ch. 123 §3, a provisional license costs $125 for a single category (mental health or SUD) and $250 for both or an integrated program. The full license that follows costs $250 or $500, and every two-year renewal costs $170 or $340. Adding a site is $50, adding a module or program is $70, and none of it is refundable. Keep in mind that DLC currently licenses mental health and SUD separately, so an organization doing both files two applications, and DLC can tell you which fee each one carries. The money that matters goes elsewhere: a building that passes the State Fire Marshal’s life safety inspection, the bond or similar security behind the closure plan, written policies, and payroll before the first client arrives.
How long does licensing take in Maine?
DLC publishes no decision deadline, and Ch. 123 does not set one, so any number is an estimate. Ours is about 3 to 5 months for an outpatient organization and roughly 6 to 9 months once beds are involved, since the pre-application letters and the fire marshal’s site work come first. That first approval is a provisional license lasting 3 to 12 months, and the two-year full license comes only after you show compliance during that term. Leave holes in the file for 60 calendar days and DLC treats the application as void, so the clock starts over.
What trips up Maine applicants most often?
Treating the license as a single event. A new organization starts provisional, and the full license is a second decision. People also miss that the application lists every service type, module and site, so starting an IOP or a second location without 30 or 90 days’ notice and DLC approval is a violation even when the main license is current. Renewal timing is the third. Ch. 123 §2(D) makes a license non-renewable once its expiration date passes, so a late filing has to go in as a brand new application.
Can a Maine license be guaranteed?
No. DLC decides, and Ch. 123 lets it refuse a license for misrepresentation, missing information or failure to meet the rule. What preparation controls is a file that answers each section DLC reviews, policies that match how the program actually runs, and a site that has already cleared life safety review.
How much staff will I need for a Maine program?
BLS reports a $59,970 median for Maine substance abuse, behavioral disorder and mental health counselors, with the middle half earning $48,090 to $73,410 (OEWS, May 2025), a shade above the $59,350 national median. Three counselors at that median come to $179,910 a year, call it $180,000, before a clinical supervisor, nursing or benefits. SUD programs also need a medical director plus certified clinical supervisors on staff or under contract (§23(D)), and residential SUD sites are staffed around the clock. Because Maine credentials counselors in tiers, a new program can build much of its clinical staff from people still climbing them. Certified alcohol and drug counselors must practice under a certified clinical supervisor, and 2,000 hours logged that way qualify them to sit for the LADC, an aide can move up to the certified credential after 4,000 supervised hours, and on the mental health side an LCPC-Conditional clinician practices under an approved supervisor while logging the 3,000 hours the LCPC requires. With a licensed supervisor guiding them at lower pay, a program usually brings clinical payroll down 40 to 60 percent from what an all-independently-licensed team would cost, and where a residential unit needs nursing, a single RN can lead a small group of LPNs at lower cost than staffing the unit with RNs alone. Your modules and census decide the final roster.
Licensing
Which office licenses what?
Everything outside a hospital goes through the DLC Behavioral Health Program, which says plainly that it “licenses Mental Health and Substance Use Disorder programs.” It issues those as two agency types, and the same page lists different statutory authority for each: 34-B MRS §3601 and §3603 for mental health, and 5 MRS §20005(6) and §20024, 22 MRS §42(1) and §8002, and 22-A MRS §205(2) for SUD. Psychiatric hospitals go to the Medical Facilities Unit in the same division, which “oversees the licensing of all hospitals” in Maine under Ch. 112. OBH funds services and appears in the rule as a recipient of notices, and it is not a licensor.
Does a solo therapist or counselor need this license?
We could not find a written exemption. 34-B MRS §1203-A licenses mental health agencies and facilities, and Ch. 123 defines the licensee as an organization that operates behavioral health programs. Neither text carves out an individual practitioner, and our reading is that neither clearly sweeps one in either. Raise it with DLC before opening, and file the written answer with your records.
Does accreditation reduce DLC oversight?
Yes, partly, and only after the full license. Both statutes (5 MRS §20024 for SUD and 34-B MRS §1203-A(8) for mental health) treat an accredited program as meeting comparable state rules once it submits written evidence to DHHS. Ch. 123 §2(M) lists the accreditors as The Joint Commission, COA, CARF and others DHHS approves, requires accreditation “without any limitation or condition,” and says DLC inspections then skip the provisions covered by the accreditation. You keep a copy of the accreditor’s standards on site, and you report any change, survey result or citation to DLC within 10 business days. NCQA does not appear in the rule.
Facility
Does a Maine behavioral health program need a Certificate of Need?
Not under Ch. 123. The CON Act’s facility list in 22 MRS §328 covers hospitals, psychiatric hospitals by name, nursing facilities and similar institutions, and it excludes “the office of a private health care practitioner.” Residential and outpatient behavioral health organizations are not on that list, so our reading is that CON reaches psychiatric hospitals and not Ch. 123 programs. For hospitals, §329 triggers include a transfer of ownership, a new health service, a capital expenditure of $10,000,000 or more for an existing facility, and a bed increase of more than 10 percent. Chapter 599, which became law on March 31, 2026 without the Governor’s signature, lifted the capital trigger for a new facility other than a nursing facility to spending above $7,500,000 (it had been $3,000,000), with yearly inflation adjustments beginning January 1, 2027. We found no emergency clause, so our reading is that it took effect July 29, 2026, the date set for that session’s nonemergency laws.
Can I run a program out of a house?
Not out of a private home. Ch. 123 §2(K) rules out private residences as treatment sites. Residential programs need a building that passes the State Fire Marshal’s life safety inspection, and a new license also needs bedrooms with 100 usable square feet for a resident sleeping alone and 80 per resident in shared rooms (§21(E)(12)).
How much notice does DLC want before changes?
Thirty calendar days to add or drop a service type, module or program, 90 days to add a site, relocate or change the name, and 30 days for a planned change of administrator (10 if unplanned). A capacity increase or new construction needs prior approval with the fire marshal. Ch. 123 §2(I) adds that nothing new may start “without Department approval.” A new owner needs a new license, since licenses do not transfer.
Staffing
What counselor credentials does Maine use?
32 MRS §6203-A defines the working credentials the State Board of Alcohol and Drug Counselors issues: alcohol and drug counseling aide, certified alcohol and drug counselor, licensed alcohol and drug counselor (LADC), and certified clinical supervisor. An aide needs a high school diploma and a supervision agreement. The certified counselor needs an associate degree, 30 college credits, a full MHRT/C or 4,000 supervised aide hours, plus the board exam. Reaching LADC, the tier allowed to practice independently, takes the advanced exam plus either 2,000 supervised hours (logged as a certified counselor or under a clinical mental health license) or 1,500 hours under a clinical mental health license combined with a master’s degree carrying 12 credits in addiction counseling.
Who has to be on the clinical team?
Before working as SUD clinical staff, a credentialed person needs a year of clinical experience in substance use treatment plus at least 60 hours of alcohol and drug coursework completed inside the last five years, and a CCS credential waives both (§13(J)). Each supervisee gets at least one hour of individual supervision a month, which the rule lets happen in person, by phone or by video, and staff without an independent license who deliver 20 or more hours of direct service a week get four hours a month (§13(H)). Someone trained in CPR has to be on site at every residential location around the clock (§21(F)(2)(b)).
Operations
How does medication for opioid use disorder fit?
MOUD is a licensed module in both outpatient and residential SUD services, and §23(H)(2) tells residential programs to “promote access to all forms of MOUD onsite or by direct coordination with outpatient providers,” or through referral. Buprenorphine now needs only a standard DEA registration, per DEA’s January 12, 2023 letter. Methadone is limited to opioid treatment programs, which carry their own per-site license, so other programs coordinate with one.
What must be reported, and how fast?
Ch. 123 sorts critical incidents into two levels. The serious kind, Level 1, covers a death, a serious injury or anything that significantly jeopardizes clients, public safety or the program, and it needs a phone call to DLC inside four hours. Either level then needs a written report within a day (§12(B)(1)). Allegations of abuse, neglect or exploitation, and of rights violations, go to DLC right away (§6(E)-(F)). Psychiatric hospitals answer to a different law, the sentinel events statute in 22 MRS ch. 1684, which the Maine Mental Health Inpatient Licensing guide walks through.
Where does MaineCare fit?
MaineCare enrollment and billing sit outside the facility license, and we don’t handle them.
Enforcement
What happens after a DLC inspection finds problems?
DLC issues a Statement of Deficiencies, and the organization then has ten business days from receiving it to return an acceptable plan of correction (§4(E)). An informal conference can be requested in writing within the same ten days, but it does not pause enforcement. DLC can also direct the plan of correction, impose a conditional license of up to 12 months, or stop new admissions. While the conditional license runs, the organization cannot grow at all: no new site, module, program or service type.
Can a lapsed or revoked license come back?
Renewal is off the table once the expiration date passes. Our reading is that the organization applies again as new and starts over with a provisional license. Revocation runs through a District Court complaint, and hearing requests go in writing to the DLC Director under 10-144 CMR Ch. 1. The details are in Maine License Reinstatement.
What’s Included and What Isn’t
What we help with in Maine
Working out which DLC license or licenses you need and which modules belong on each, building the application and policy set, preparing sites for fire marshal and DLC review, moving from provisional to full licensure, and readying accredited organizations to request deemed status under §2(M).
What falls outside that scope
We don’t take on CMS, Medicare or Medicaid enrollment, billing, or payer contracts, and we don’t do marketing. We can suggest people who specialize in either.
Treating both addiction and mental illness in Maine currently means two applications. Tell us what you are planning and we can sort out which license covers which service.
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
- Maine DHHS, DLC Behavioral Health Program (separate MH and SUD licenses, statutory authority, forms, submission, contacts): Behavioral Health (checked October 13, 2026)
- Maine DHHS, DLC Hospitals (Medical Facilities Unit, Ch. 112, application request): Hospitals (checked October 13, 2026)
- Maine DHHS, DLC Certificate of Need program: Certificate of Need (checked October 13, 2026)
- Maine DHHS, Ch. 123 rulemaking record (repealed rules, one-stop rule): 10-144 CMR Ch. 123 rulemaking (checked October 13, 2026)
- Maine DHHS bulletin (Ch. 123 effective February 11, 2024): DHHS bulletin (checked October 13, 2026)
- 10-144 CMR Ch. 123, purpose and applicability, via Cornell LII (verbatim mirror): Purpose and Applicability (checked October 13, 2026)
- 10-144 CMR Ch. 123 §1, definitions and critical incident levels (Cornell LII): Section 1 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §2, licensing, changes, deeming (Cornell LII): Section 2 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §3, fees (Cornell LII): Section 3 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §4, enforcement and hearings (Cornell LII): Section 4 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §6, rights violations and abuse reporting (Cornell LII): Section 6 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §12, incident reporting (Cornell LII): Section 12 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §13, personnel (Cornell LII): Section 13 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §21, residential standards (Cornell LII): Section 21 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §22, mental health programs (Cornell LII): Section 22 (checked October 13, 2026)
- 10-144 CMR Ch. 123 §23, SUD programs, ASAM placement, MOUD (Cornell LII): Section 23 (checked October 13, 2026)
- 10-144 CMR Ch. 123, Appendix A, modules and services (Cornell LII): Appendix A (checked October 13, 2026)
- 34-B MRS §1203-A (license, monitoring, deemed status, penalty): 34-B §1203-A (checked October 13, 2026)
- 5 MRS §20024 (SUD deemed status): 5 §20024 (checked October 13, 2026)
- 22 MRS ch. 1667 (drug treatment centers): Chapter 1667 (PDF) (checked October 13, 2026)
- 22 MRS §1811 (hospital license required, ch. 405): 22 §1811 (checked October 13, 2026)
- 22 MRS ch. 1684 (sentinel events): Chapter 1684 (PDF) (checked October 13, 2026)
- Public Law 2025, chapter 305 (LD 1961), chaptered text: LD 1961 (checked October 13, 2026)
- Office of Policy and Legal Analysis, Legislative Digest (September 24, 2025 effective date): Legislative Digest, 132nd Legislature (checked October 13, 2026)
- 22 MRS §328 (CON definitions): 22 §328 (checked October 13, 2026)
- 22 MRS §329 (CON triggers, PL 2025 c. 599): 22 §329 (checked October 13, 2026)
- LD 1890, Committee Amendment A (threshold to $7.5 million): LD 1890 amendment (checked October 13, 2026)
- Maine House, Weekly Legislative Report, April 3, 2026 (Ch. 599 became law without signature): Weekly Legislative Report (checked October 13, 2026)
- Laws of Maine, 132nd Second Regular Session (July 29, 2026 general effective date): Second Regular Session laws (checked October 13, 2026)
- Maine DHHS, Office of Behavioral Health: About OBH (checked October 13, 2026)
- State Board of Alcohol and Drug Counselors, licensing and forms: Licensing and forms (checked October 13, 2026)
- 32 MRS §6203-A (counselor titles): 32 §6203-A (checked October 13, 2026)
- Maine Board of Counseling Professionals Licensure, FAQ (LCPC-Conditional, 3,000 hours): Frequently asked questions (checked October 13, 2026)
- DEA Diversion Control Division, Dear Registrant letter, January 12, 2023: DEA letter (PDF) (checked October 13, 2026)
- CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 13, 2026)
- CARF provider search: Find a Provider (checked October 13, 2026)
- ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 13, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: OEWS tables (checked October 13, 2026)