Minnesota Mental Health Outpatient 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.

A therapy practice in Minnesota does not need a state license to open. The 2025 text of Minn. Stat. 245A.03 lists “mental health outpatient services for adults with mental illness or children with mental illness” among the services the human services licensing law does not cover, so the practice runs on its clinicians’ individual board licenses. What the Department of Human Services (DHS) offers instead is voluntary. A practice that wants to call itself a certified mental health clinic has to be certified under section 245I.20 and then follow the parts of chapter 245I that apply to license holders (245I.011, subd. 3). Nobody makes you do it, and once you do, a good deal of chapter 245I comes with the title.

Certified Clinic or Uncertified Practice

Built from sections 245I.011, 245I.20 and 245A.10 and DHS’s 2026 clinic plan.

One caution on the statute number. A 2026 law recodified section 245A.03 effective August 1, 2026, and DHS says the change “does not change DHS’ practices.” We have not confirmed whether the outpatient mental health exclusion kept its old clause number, so cite the section rather than the clause in anything you send the state.

What Certification Under 245I.20 Asks of a Clinic

Drawn from the text of section 245I.20 as the Revisor publishes it.

The purpose clause describes clinics that provide clinical services for the treatment of mental illnesses through a treatment team spanning several disciplines, and the staffing rule makes that concrete. “A certification holder’s treatment team must consist of at least four mental health professionals,” with two of them working at least 35 hours a week as employees or contractors. The team must include a physician or nurse and a psychologist who each qualify as mental health professionals, and those required members must provide clinical services on a schedule tied to the clinic’s size, from two hours a month for a team of 2.0 to 5.0 full-time equivalents up to eight hours every two weeks above 25.0. Satellites follow the main location’s policies and need a mental health professional reachable for supervision, in person or by phone, whenever they are open.

The process is plain on paper. DHS must act within 90 working days of a complete application. An incomplete first application earns written notice and 45 days to submit a complete one, and a denial can be appealed within 20 calendar days. DHS may review a clinic every two years, gives notice and a choice of dates, and publishes review results on its website. The 2026 clinic implementation plan adds a date to put on the calendar: “the application fee for mental health clinic certification was increased to $2,100” as part of the chapter 245I changes that take effect January 1, 2028. The Revisor’s page also marks subdivision 9, the quality assurance and improvement plan requirement, as repealed by the same 2026 law (chapter 121, article 7, section 55), which falls in the article DHS dates to January 1, 2028. DHS covers clinic certification in its application webinars, and the licensing unit answers at 651-431-6500 and dhs.mhcdlicensing@state.mn.us.

Why certify at all? Our reading of 245I.011 is that the title itself is the benefit the statute grants: only a certified clinic may present itself as a certified mental health clinic. If the real reason is a payer or county contract that asks for certification, that relationship sits outside the license, and it is not something we handle.

When a Therapy Practice Becomes a Licensed SUD Program

This is the line Minnesota practices cross without noticing. A licensed professional in private practice is exempt from the 245G substance use disorder license, but 245G.01 defines that person as someone working within their own license who “does not affiliate with other licensed or unlicensed professionals to provide alcohol and drug counseling services.” Our reading is that a group mental health practice adding a substance use track staffed by several clinicians has become a 245G program. That brings the $2,100 application, a treatment director, an alcohol and drug counselor supervisor, and written notice to the county human services director at least 60 days before the application goes in (254B.03, subd. 2(c)). The full process is in Minnesota Drug and Alcohol Outpatient Treatment Licensing.

Ketamine and Spravato in a Minnesota Outpatient Mental Health Practice

Minnesota’s licensing statutes are silent on ketamine. How the provisions below apply to an office practice is our reading of them. Federal points come from the regulation and the FDA label.

Because Minnesota does not license outpatient mental health at all, adding ketamine raises no new facility license question for an uncertified practice. The obligations land on each prescriber individually: a DEA registration, a PMP account and the limits of their own scope of practice. A certified clinic is in a similar spot: 245I.20 is written around mental health services and team structure, and nothing we read there mentions ketamine, so ask DHS before describing ketamine as a service of the certified clinic. The Minnesota Department of Health (MDH) will not license the space either. Minn. Stat. 144.55 defines an outpatient surgical center as a facility for elective outpatient surgery and says the term does not include “a physician’s, advanced practice registered nurse’s, physician assistant’s” office or clinic for the practice of medicine (144.55, subd. 2). Our reading is that an infusion room in a psychiatric practice needs no MDH facility license.

Registration is lighter than in many states. Ketamine is Schedule III federally (21 CFR 1308.13(c)(7)), so each prescriber needs a DEA registration. The Minnesota Board of Pharmacy says the state “does not require a separate registration, license, or credential specifically for controlled substances,” which we read as covering prescribers too. Every prescriber who holds a DEA registration and a license from a health-related board must register with the Minnesota Prescription Monitoring Program (PMP registration requirements). Reporting is narrower. Section 152.126 says dispensing “does not include the direct administering of a controlled substance,” so a dose given in the office is not reported, while a dispensing practitioner who sends medication home must report it (PMP reporting page). The mandatory PMP check in subdivision 6(d) is triggered by an initial prescription for a Schedule II through IV opiate, which by our reading ketamine alone does not trip.

Nurse practitioners can prescribe it. Under Minn. Stat. 148.235, subd. 7a, an APRN may “prescribe, procure, sign for, record, administer, and dispense” controlled substances, and subdivision 7b requires filing the nurse’s DEA registrations with the Board of Nursing. A new NP still practices 2,080 hours under a collaborative agreement (148.211, subd. 1c). According to the APRN practice changes summary posted on the Minnesota boards site, the 2026 law that took effect August 1, 2026 removed the old hospital or integrated-setting language and requires a setting where APRNs and physicians work together only for services other than primary care or mental health, which leaves a psychiatric NP’s first 2,080 hours more flexible than before. If RNs will run infusions, the Board of Nursing’s statement on RN administration of anesthetics lets them give anesthetic-class drugs once they have the knowledge and skills, excludes LPNs, and lists the vital signs to watch. Spravato is the one product here with a federal site requirement. Its label limits use to “healthcare settings certified in the SPRAVATO REMS program” and calls for observing the patient for at least two hours.

Settle who owns the practice before buying an infusion pump. Minnesota’s Supreme Court recognized in 2005 that “with limited exceptions, the corporate practice of medicine doctrine exists in Minnesota” (Isles Wellness), and Minn. Stat. 319B.07 lets only licensed professionals and a few listed categories own a professional firm. If the people who own your counseling group are not physicians or APRNs, the management-company arrangement described in the ketamine section of Minnesota Drug and Alcohol Outpatient Treatment Licensing is the usual answer.

Staffing a Minnesota Outpatient Mental Health Practice

Certification fixes the floor at four mental health professionals. Without it, size is the owner’s call, and in our experience many Minnesota group practices open with three or four clinicians. BLS reports a $58,780 median wage for Minnesota substance abuse, behavioral disorder and mental health counselors, and the 25th to 75th percentile band running from $48,910 to $65,430 (BLS OEWS, May 2025), against $59,350 nationally. Our arithmetic puts four clinicians at that median near $235,000 a year before benefits. Chapter 245I gives practices a lawful way to pay well under that. Under section 245I.04, a clinical trainee (someone enrolled in an accredited graduate program and placed with the practice, or a graduate still completing board requirements) may deliver psychotherapy while a mental health professional provides treatment supervision, the supervisor being a mental health professional under 245I.04, such as an LICSW, LPCC, LMFT or licensed psychologist, and that supervision can count toward their board’s supervised practice where the board permits. Pairing a fully licensed clinical lead with trainees at lower wages while they complete their hours typically brings clinical payroll down 40 to 60 percent from what a team of fully licensed therapists would cost. A certified clinic still needs its four qualifying professionals, so trainees add capacity on top of that core rather than replacing it, and where the practice needs nursing, an RN supervising LPNs is cheaper than an all-RN nursing line. Caseload and service mix are what a real staffing estimate starts from.

Where Minnesota Outpatient Practices Go Wrong

Most trouble starts with the substance use exemption. A practice reads that private practitioners are exempt from 245G, adds three clinicians doing substance use counseling as a group, and finds out later that the exemption never covered them. The other common problem is certifying for the wrong reason, taking on chapter 245I duties, background studies for every direct-contact staff person and volunteer included, when the practice only needed its clinicians’ licenses.

Frequently Asked Questions

Unsure if 245I.20 certification earns its keep? Ask us about your practice.

Sources

• Minn. Stat. ch. 245A, including 245A.03: Chapter 245A full text (checked October 11, 2026)
• Minn. Stat. ch. 245I, including 245I.011: Chapter 245I (PDF) (checked October 11, 2026)
• Minn. Stat. 245I.20 (mental health clinic): 245I.20 (checked October 11, 2026)
• Minn. Stat. 245I.04 (mental health professionals, clinical trainees): 245I.04 (PDF) (checked October 11, 2026)
• Minn. Stat. 245A.10 (fees): 245A.10 (checked October 11, 2026)
• Minnesota DHS, MHC Implementation Plan for 2026 Legislative Changes: MHC 2026 plan (PDF) (checked October 11, 2026)
• Minnesota DHS, IRTS-RCS Implementation Plan for 2026 Legislative Changes (245A.03 recodification note): IRTS-RCS 2026 plan (PDF) (checked October 11, 2026)
• Minnesota DHS, Behavioral Health Application Information Session: Application information session (checked October 11, 2026)
• Minnesota DHS, Substance Use Disorder Treatment licensing (licensing unit contacts): Licensing unit contacts (checked October 11, 2026)
• Minn. Stat. 245G.01 (licensed professional in private practice): 245G.01 (checked October 11, 2026)
• Minn. Stat. 245G.02 (exemptions): 245G.02 (checked October 11, 2026)
• Minn. Stat. 254B.03 (county notice): 254B.03 (checked October 11, 2026)
• MDH, Hospital licensing page: Hospitals (checked October 11, 2026)
• Minn. Stat. 144.55 (outpatient surgical center definition): 144.55 (checked October 11, 2026)
• 21 CFR 1308.13(c)(7), via Cornell LII: Ketamine in Schedule III (checked October 11, 2026)
• Minnesota Board of Pharmacy, General FAQs: General FAQs (checked October 11, 2026)
• Minn. Stat. 152.126 (prescription monitoring program): 152.126 (PDF) (checked October 11, 2026)
• Minnesota PMP, registration requirements: Registration requirements (checked October 11, 2026)
• Minnesota PMP, reporting requirements: Reporting (checked October 11, 2026)
• Minn. Stat. 148.235 (APRN prescribing): 148.235 (checked October 11, 2026)
• Minn. Stat. 148.211 (APRN licensure, collaborative practice): 148.211 (checked October 11, 2026)
• MN APRN Practice Changes (8/21/2026), Minnesota boards site: APRN practice changes (PDF) (checked October 11, 2026)
• Minnesota Board of Nursing, RN administration of anesthetics (revised August 2024): Statement of accountability (PDF) (checked October 11, 2026)
• U.S. FDA, Spravato prescribing information and Medication Guide: Spravato label (PDF) (checked October 11, 2026)
• Isles Wellness, Inc. v. Progressive Northern Ins. Co. (Minn. 2005), via Justia: Opinion (checked October 11, 2026)
• Minn. Stat. 319B.07 (professional firm ownership): 319B.07 (checked October 11, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: OEWS tables (checked October 11, 2026)