This page is for the people who own, run or clinically lead an Oklahoma addiction or mental health program that is opening, changing hands, relocating or coming up for renewal, and for out-of-state groups that want to see what Oklahoma does its own way.
Additional Oklahoma Licensing Guides
- Oklahoma Drug and Alcohol Inpatient Treatment Licensing
- Oklahoma Drug and Alcohol Outpatient Treatment Licensing
- Oklahoma Mental Health Inpatient Licensing
- Oklahoma Mental Health Outpatient Licensing
- Oklahoma License Reinstatement
Oklahoma Certifies Instead of Licensing, and Skipping It Is a Crime
The statute, rule and agency quotes in this section come from the Oklahoma Statutes on OSCN and from ODMHSAS’s and OSDH’s own pages. The last paragraph says where we are drawing our own conclusion.
Ask the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) for a treatment license and you will be corrected. The department certifies programs through its Provider Certification unit, and its page is blunt that “ODMHSAS certifies organizations as the program types listed above, not individuals.” The softer word hides a hard rule. Under 43A O.S. 3-415, “Only certified facilities may receive and assist alcohol- and drug-dependent persons by providing treatment, recovery support and rehabilitation,” and anyone who runs an uncertified substance use program “upon conviction, shall be guilty of a misdemeanor.” Community mental health centers and community-based structured crisis centers face the same operate-only-if-certified language in 43A O.S. 3-306.1 and 3-317.
The path to that certification also runs differently from most states. A new program does not open on a finished certificate. The first approval is a Permit for Temporary Operations (PTO), which goes to a vote of the ODMHSAS Board of Directors, and the agency’s own overview calls the PTO “actually a license to allow the provider to begin offering services.” It lasts six months. Before it runs out, Provider Certification comes back to review records, at least five active charts plus discharge records, before full certification is awarded.
Two more things trip up operators who arrive with older notes. Oklahoma repealed its Psychiatric and Chemical Dependency Facility Certificate of Need Act (63 O.S. 1-880.1 through 1-880.11) through HB 2330, which the Governor approved on May 6, 2024 with an emergency clause. ODMHSAS also revoked the CON subchapters in its own rules. Yet OSDH’s Health Resources Development Service web page continues to describe itself as the office that “administers the certificate of need regulations for nursing facilities and psychiatric and chemical dependency facilities,” and the Provider Certification page still mentions an ODMHSAS Certificate of Need for new residential providers. That ODMHSAS mention is tied to SoonerCare reimbursement, not to certification. We read both as agency text that has not caught up with the 2024 repeal, so confirm with the agency before you budget for a CON. And psychiatric hospitals sit with a different department altogether, the Oklahoma State Department of Health (OSDH), which is why we treat Oklahoma as a split-agency state.
Primary Regulatory Agencies
Roles below are described the way each agency or statute describes them.
- ODMHSAS Provider Certification, which certifies alcohol and drug treatment programs at every level in its Chapter 18 rules, community mental health centers, community-based structured crisis centers and several other program types under Title 43A
- OSDH Medical Facilities Service, Facility Services Division, which licenses hospitals, including the “Specialized Hospital: Psychiatric” type on application Form ODH 920
- Oklahoma Board of Licensed Alcohol and Drug Counselors, which licenses LADCs and certifies CADCs under OAC Title 38, Chapter 10
Oklahoma Behavioral Health Licensing Snapshot
Every value below is taken from the statute, rule or agency page cited beside it. The CON row follows the 2024 repeal rather than the older agency pages.
| Primary SUD Regulator | ODMHSAS Provider Certification (43A O.S. 3-415, OAC 450 Chapters 1 and 18) |
| Mental Health Facility Licensing | ODMHSAS certifies community mental health centers and crisis centers. OSDH licenses psychiatric hospitals. Residential care homes are licensed by OSDH, with ODMHSAS certification only for homes under contract with ODMHSAS |
| Residential Treatment | ODMHSAS certification at ASAM 3.1 (halfway house), 3.3 (adults with co-occurring disorders) and 3.5 (residential), per OAC 450:18-13-1 |
| Outpatient Treatment | ODMHSAS certification for outpatient services at ASAM Level 1. The Chapter 18 part for intensive outpatient is marked revoked |
| Withdrawal Management | Medically supervised withdrawal management carries the ASAM 3.7 label in Oklahoma’s rule. Providers certified at 3.3 or 3.5 must also offer non-medical withdrawal management (OAC 450:18-5-14) |
| Facility License Required | Yes for SUD treatment, CMHCs and crisis centers (certification to operate). Yes for psychiatric hospitals (OSDH hospital license) |
| Certificate of Need | None for psychiatric or chemical dependency facilities since the 2024 repeal (HB 2330). Oklahoma’s remaining CON law covers long-term care |
| National Accreditation | Not required to operate. ODMHSAS may accept TJC, CARF or COA accreditation as compliance with certain standards (OAC 450:1-9-7.3), and accreditation qualifies a program for Certification with Special Distinction of up to three years |
| Inspection | Initial health and safety site visit before the Board’s PTO decision, then a records review before the six-month PTO expires |
| License Renewal | Certification for one or two years, or up to three with Distinction or Special Distinction. Renewal materials are due within 60 days of ODMHSAS’s expiration notice (OAC 450:1-9-7.2). Fee $1,000 per certification period for treatment programs |
| Key Regulations | 43A O.S. 3-415, 3-306.1, 3-317 and 3-324, OAC 450 Chapters 1, 16, 17 and 18, OSDH hospital licensing (Form ODH 920), OAC Title 38 Chapter 10 (counselors), 63 O.S. 1-880.12 (patient brokering) |
Which Oklahoma Office Handles Which Program
No state document arranges programs this way. The grouping is ours, built from the rules and pages cited in each row.
| Program | Agency and approval | Rule or statute | Accreditation’s role |
|---|---|---|---|
| Halfway house, ASAM 3.1 | ODMHSAS certification | OAC 450:18-13-181 | Partial credit toward standards, plus Special Distinction eligibility |
| Co-occurring residential, ASAM 3.3 | ODMHSAS certification | OAC 450:18-13-141 | Same |
| Residential treatment, ASAM 3.5 | ODMHSAS certification | OAC 450:18-13-101 | Same |
| Medically supervised withdrawal management, ASAM 3.7 | ODMHSAS certification | OAC 450:18-13-61 | Same |
| Outpatient SUD, ASAM Level 1 | ODMHSAS certification | OAC 450:18-13-21 | Same |
| Community mental health center | ODMHSAS certification | 43A O.S. 3-306.1, OAC 450 Chapter 17 | Required for any CMHC inpatient service |
| Psychiatric hospital | OSDH hospital license | Form ODH 920, 63 O.S. 1-703 and 1-704 as cited on the form | Not addressed on the form |
| Private outpatient therapy practice | No operating license found | Clinicians practice on their own licenses | No licensing effect we could find |
Oklahoma prints ASAM numbers right in its level-of-care rule, which makes the outside credential worth thinking through carefully. CARF’s ASAM Level of Care Certification, delivered in partnership with ASAM, covers adult residential programs at 3.1, 3.5 and 3.7, and neither organization’s page describes it as a withdrawal management credential at any level. Oklahoma uses the 3.7 number in its own way. OAC 450:18-13-1 gives the 3.7 label to medically supervised withdrawal management, which OAC 450:18-13-61 describes as a service delivered outside a medical facility under a physician, APRN or PA and an RN supervisor. So an Oklahoma halfway house (3.1) or residential program (3.5) can seek CARF’s certification at the matching level, and a program delivering residential care at the 3.7 intensity can seek CARF’s 3.7, but that certificate speaks to residential treatment, not to detox, and holding ODMHSAS’s 3.7 withdrawal management certification does not by itself line up with CARF’s 3.7. That separation is our reading of the two sets of documents. Oklahoma’s 3.3 co-occurring level has no CARF counterpart. We found nothing in Chapter 18 that requires the CARF credential, and it is separate from ODMHSAS certification, so to confirm a provider’s claim use CARF’s provider search and tick the “ASAM Level of Care 3.7” box (3.1 and 3.5 have their own boxes).
Programs Covered
- Halfway house, co-occurring residential and residential SUD treatment (ASAM 3.1, 3.3 and 3.5)
- Medically supervised withdrawal management (ASAM 3.7 in Oklahoma’s rule)
- Outpatient SUD treatment (ASAM Level 1)
- Community mental health centers and outpatient mental health practices
- Psychiatric hospitals and community-based structured crisis centers
Key Licensing Requirements
Pulled from ODMHSAS’s new-program overview, OAC 450 Chapter 1 and the OSDH hospital form.
- A certification application packet requested by email from Provider Certification at ProviderCert@odmhsas.org, along with the $1,000 fee Chapter 1 charges treatment programs
- Proof the building passed a fire inspection by the local fire department or the State Fire Marshal, plus a zoning compliance statement on official letterhead from the local zoning office
- Policies and procedures that pass ODMHSAS review, which the agency allows up to three rounds of before a possible denial
- All requested materials within 60 days of ODMHSAS receiving the application, or the application is denied (OAC 450:1-9-7)
- For a psychiatric hospital, Form ODH 920 to OSDH with the supporting forms (ODH 892, 911, 928 and 929) and a fee of $10 per licensed bed
Frequently Asked Questions
What does Oklahoma behavioral health certification cost?
ODMHSAS charges treatment programs $1,000 for each certification period under OAC 450:1-9-6, which is also the most 43A O.S. 3-324 lets it charge per certification. Community residential mental health programs pay $100. A psychiatric hospital pays OSDH $10 for each licensed bed on Form ODH 920. Since the 2024 repeal there is no psychiatric or chemical dependency CON fee to plan around. Fees are a rounding error next to the lease, the build-out for the fire inspection and the months of payroll you carry before the PTO is granted.
How long does it take to get certified in Oklahoma?
ODMHSAS publishes no overall deadline. The sequence is application, policy review, an initial site visit, a Board vote on the Permit for Temporary Operations and then a PTO phase the agency says lasts approximately six months before full certification. For budgeting we assume, as our own estimate rather than anything the state publishes, 6 to 9 months from application to full certification for an outpatient program and 8 to 12 months for residential, which adds fire, zoning and 24-hour staffing work before the site visit.
What slows Oklahoma applications down most?
Three habits show up again and again. Programs start seeing clients before the PTO, which under OAC 450:1-9-7.4 can bring a denial and an order to stop services if they do not reach compliance within 20 working days. Applicants let missing documents sit, and the rule denies an application with materials still outstanding after 60 days. And people plan around a Certificate of Need that was repealed in May 2024 because two agency web pages still describe one.
Can certification in Oklahoma be guaranteed?
No. The ODMHSAS Board votes on every PTO and Provider Certification decides whether the records review passes, so no outside party controls the result. What can be controlled is a packet that answers the Chapter 1 and Chapter 18 standards the first time, so the policy review does not burn its three rounds.
How much staff will an Oklahoma program need?
Chapter 18 sets the floor. Outpatient therapy must come from a Licensed Behavioral Health Professional or a Licensure Candidate, a 3.5 residential program needs staff on site around the clock with a physician reachable by phone at all hours, and a 3.7 withdrawal management unit needs an RN supervising on site around the clock with no fewer than two staff present. BLS reports a $59,350 median for Oklahoma substance abuse, behavioral disorder and mental health counselors, with a 25th percentile of $41,930 and a 75th of $79,620 (BLS OEWS, May 2025), and that median matches the national one in the same release. Put three counselors on payroll at that median and base pay alone reaches about $178,050 a year, with benefits on top. Oklahoma’s rules leave real room to bring that number down without cutting corners. Because Chapter 18 lets a Licensure Candidate under board-approved supervision deliver therapy, and lets a CADC deliver rehabilitation and case management, a program can pair one licensed clinical lead with candidates working through their supervised hours toward full licensure at lower pay, which commonly cuts the counseling payroll 40 to 60 percent below what a fully licensed team would cost. On a 3.7 unit, one RN supervising several LPNs across a shift costs less than staffing each post with an RN. The final headcount depends on the levels you certify and your expected census.
Licensing
Who is exempt from ODMHSAS certification for substance use treatment?
43A O.S. 3-415(E) lists the exemptions. Licensed hospitals, including psychiatric facilities, are out. So are individual practitioners in private practice, a list that runs from physicians and psychologists through social workers, registered nurses, LPCs, LMFTs, licensed behavioral practitioners, LADCs and CADCs, but the statute limits that to “individual professional persons in their private practice” and “not to any treatment facility operated by the person.” Residential recovery-based programs with fewer than twelve residents are exempt, which we read as covering recovery residences rather than treatment programs. Federally defined health centers are exempt except for “services listed in Levels 2.1 through 4 of the Levels of Care.”
Does accreditation replace ODMHSAS certification?
Not for substance use treatment. Under OAC 450:1-9-7.3(b), ODMHSAS “may accept” Joint Commission, CARF or COA accreditation “as compliance with certain specific ODMHSAS standards,” and it can still monitor and verify. That is partial credit, not deemed status, and the PTO and site review still happen. Accreditation does buy a longer certificate: Certification with Special Distinction, for up to three years, requires national accreditation for the certified services and at least a year of prior ODMHSAS certification. Outpatient mental health follows a different logic, which Oklahoma Mental Health Outpatient Licensing explains.
What certification types can ODMHSAS award?
OAC 450:1-9-5.7 sets the ladder. A Permit for Temporary Operations runs six months and can be extended up to 90 days in extenuating circumstances. Full Certification is awarded for one or two years, Certification with Distinction for up to three, and Certification with Special Distinction for up to three with accreditation. When majority ownership or majority board composition changes while the program keeps operating, ODMHSAS may award a one-year Probationary certification.
Facility
What does ODMHSAS want to see about the building?
The new-program overview asks for a fire inspection from “a local fire department or the State Fire Marshal” and a written statement of zoning compliance on official letterhead. Adding a second location under a certification in good standing does not need a new PTO unless the new site will offer services the existing certification does not cover (OAC 450:1-9-6.1).
Is there a Certificate of Need for a new residential or psychiatric facility?
No, not since May 6, 2024. HB 2330 repealed 63 O.S. 1-880.1 through 1-880.11, and the ODMHSAS rule subchapters on CON (450:18-17 and 450:24-27) are revoked. Oklahoma’s surviving CON statute is the Long-term Care Certificate of Need Act. The OSDH CON page and acquisition Form ODH 618-P still describe psychiatric and chemical dependency review, so if you are buying or building, ask OSDH and ODMHSAS in writing to confirm nothing applies to your project.
Does a psychiatric hospital need ODMHSAS certification too?
For substance use services, no. Properly licensed hospitals, “psychiatric and medical surgical facilities,” are exempt under 43A O.S. 3-415(E)(2). The hospital license itself comes from OSDH. A community mental health center that wants inpatient beds is different: OAC 450:17-5-95 requires TJC, CARF or COA accreditation plus OSDH licensure for that service. Oklahoma Mental Health Inpatient Licensing covers both routes.
Staffing
Which counselor credentials does Oklahoma issue?
The Board of Licensed Alcohol and Drug Counselors licenses the LADC and certifies the CADC under OAC 38:10-7-2. An LADC needs a master’s degree in a counseling field and 2,000 hours of work experience, at least 1,000 of them in direct client contact, plus oral and written exams. A licensed mental health professional can qualify with 15 hours of master’s-level substance use coursework. The CADC calls for a bachelor’s in a behavioral science, 4,000 hours of supervised work experience, 270 clock hours of education, 45 hours of co-occurring training and a 300-hour practicum. An LADC who qualifies for mental health work carries the LADC/MH designation on the license. The board’s basic requirements sheet lists a $175 application fee for each.
Who can deliver services in an ODMHSAS outpatient SUD program?
OAC 450:18-13-21 assigns therapy to a Licensed Behavioral Health Professional or Licensure Candidate, rehabilitation to those two or a CADC or Case Manager II, and case management to any of those or a Case Manager I. Peer recovery support is limited to specialists who hold ODMHSAS peer certification under OAC 450:53.
Operations
Must an Oklahoma program give clients access to MAT medications?
For residential, medically supervised withdrawal management and halfway house programs, yes in substance. OAC 450:18-5-5.1 says they “shall provide access to medication assisted treatment (MAT) medications” to every consumer for whom MAT is appropriate, either directly “or provided through a formal agreement with a separate MAT provider.” We found no matching duty for outpatient programs in Chapter 18. DEA’s letter of January 12, 2023 ended the separate DATA-Waiver, so an ordinary DEA registration now covers buprenorphine prescribing. Methadone comes from an opioid treatment program certified separately under OAC 450 Chapter 70, so residential programs coordinate with one.
How fast must incidents be reported to ODMHSAS?
Under OAC 450:1-9-5.6(f), sentinel events and allegations of consumer abuse go to ODMHSAS “immediately not to exceed twenty-four (24) hours,” and other critical incidents that need medical care or hospitalization within 72 hours. Oklahoma’s sentinel event definition reaches deaths within 72 hours of discharge from inpatient and residential settings. ODMHSAS takes these reports by fax at 405-248-9325, a line it reserves for critical incidents. Community mental health centers also owe a root cause analysis within 30 days of a sentinel event (OAC 450:17-15-5).
Does Oklahoma regulate paid referrals?
Yes. Under 63 O.S. 1-880.12, paying or taking anything of value to secure or solicit patients for a psychiatric or chemical dependency facility is a misdemeanor carrying a $500 to $2,000 fine. The section’s definition of a health care provider includes private facilities certified under Title 43A. It survived the 2024 CON repeal. Safe harbors cover non-deceptive advertising, fair-market marketing pay set in advance and not tied to referral volume, and anything the federal anti-kickback statute permits.
Enforcement
What sanctions can ODMHSAS impose?
OAC 450:1-5-4 lists revocation, reduction, suspension and reprimand. A full-text search of the 2025 Chapter 1 rules found no fine provision, but the costs of a sanction proceeding are surcharged to the sanctioned party. A failure to show substantial compliance can bring immediate suspension or revocation, and the Commissioner or a hearing officer can order summary suspension when public health or safety requires it (OAC 450:1-5-5.2).
How long do I have to respond?
Ten calendar days from receiving the petition and notice to ask for a hearing (OAC 450:1-5-5), then 15 calendar days to ask the Board to review the hearing officer’s proposed order (OAC 450:1-9-9.1). After a suspension or revocation order, a program cannot reapply for twelve months, and the sanction costs must be paid first. Oklahoma License Reinstatement walks through the waiting periods in detail.
Where We Fit on an Oklahoma Project
The work we take on
Building the Chapter 18 or Chapter 17 policy manual that ODMHSAS reviews, preparing a program for the initial site visit and the records review that ends the PTO, positioning an accredited program for Special Distinction, and working out which agency, if any, a mental health project has to answer to.
Work we hand off
SoonerCare enrollment, billing, payer contracts and marketing are outside what we do. We can point you to people who handle them.
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
- ODMHSAS Provider Certification (program types, certification versus accreditation, application contact): Provider Certification (checked October 16, 2026)
- ODMHSAS, new programs overview (PTO, records review, fire and zoning items, phone and critical incident fax): Overview of the ODMHSAS Certification Process (checked October 16, 2026)
- OAC 450 Chapter 1 (eff. September 1, 2025), certification types, fees, renewal, accreditation, sanctions, incidents: Chapter 1 (PDF) (checked October 16, 2026)
- OAC 450 Chapter 18 (eff. September 1, 2025), levels of care, staffing, MAT access, revoked CON subchapter: Chapter 18 (PDF) (checked October 16, 2026)
- OAC 450 Chapter 17 (eff. July 11, 2026), community mental health centers: Chapter 17 (PDF) (checked October 16, 2026)
- OAC 450 Chapter 16 (eff. September 1, 2025), community residential mental health: Chapter 16 (PDF) (checked October 16, 2026)
- OAC 450 Chapter 24 (eff. September 1, 2025), revoked CON subchapter: Chapter 24 (PDF) (checked October 16, 2026)
- 43A O.S. 3-415, OSCN: Certification of facilities, exemptions, misdemeanor (checked October 16, 2026)
- 43A O.S. 3-306.1, 3-317 and 3-324, OSCN: 3-306.1, 3-317 and 3-324 (checked October 16, 2026)
- 2024 O.S.L. 275 (HB 2330), repeal of 63 O.S. 1-880.1 to 1-880.11: HB 2330 enrolled act (OSCN), HB 2330 bill history (Oklahoma Legislature) and Title 63 official compilation (PDF) (checked October 16, 2026)
- 63 O.S. 1-880.12, OSCN: Patient brokering (checked October 16, 2026)
- Long-term Care Certificate of Need Act, 63 O.S. 1-851 et seq., OSCN: Long-term care certificate of need section (checked October 16, 2026)
- OSDH Health Resources Development Service: HRDS page and Form ODH 618-P (PDF) (checked October 16, 2026)
- OSDH Medical Facilities Service: Medical Facilities, licensure applications and forms and Form ODH 920 (PDF) (checked October 16, 2026)
- Oklahoma Board of Licensed Alcohol and Drug Counselors: Laws and rules, OAC Title 38 rules (PDF) and Basic requirements (PDF) (checked October 16, 2026)
- ODMHSAS, Guidance for Reporting Critical Incidents and Sentinel Events: CIR guidance (PDF) (checked October 16, 2026)
- ODMHSAS, administrative rules in effect (Chapter 70 opioid treatment programs listed separately): Rules currently in effect (checked October 16, 2026)
- DEA Diversion Control Division, Dear Registrant letter (January 12, 2023): DEA letter (PDF) (checked October 16, 2026)
- CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 16, 2026)
- ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 16, 2026)
- CARF provider search: Find a Provider (checked October 16, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, Oklahoma, SOC 21-1018: Oklahoma OEWS and national estimates (checked October 16, 2026)