New York 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: OASAS Program Certification | Questions: Certification@oasas.ny.gov, (518) 485-2250 (OASAS certification line)

Outpatient SUD treatment in New York is certified by the Office of Addiction Services and Supports (OASAS) under 14 NYCRR Part 822, and a Part 822 provider generally needs an operating certificate issued under Part 810. Outpatient, opioid treatment programs included, is also where OASAS runs its deeming initiative, and only general hospitals can use it.

Prior Approval Applies to Outpatient Too

A smaller footprint doesn’t earn an outpatient project any shortcut through this process. Outpatient programs go through the same prior approval process under 14 NYCRR Part 810 as residential ones. Before you file, OASAS wants a concept discussion with both your Regional Office and the Local Governmental Unit, and its certification page says that in most cases you’ll need a Prior Consultation form signed by both, plus prior approval from the LGU. A smaller physical footprint doesn’t reduce this requirement.

Deemed Status Is Real Here, But Only for Hospital-Operated Programs

The eligibility window here is narrower than the headline benefit suggests. Mental Hygiene Law § 32.14 applies to general hospitals, and OASAS uses it to let a hospital’s Joint Commission survey take the place of a separate OASAS recertification review for its Part 822 Outpatient Programs and Opioid Treatment Programs. OASAS then issues the renewal operating certificate based on the results of that survey. OASAS describes deeming only in terms of renewal certificates, so our reading is that initial certification still runs through Part 810 in the usual way. To take part, all of the hospital’s OASAS-certified programs need an operating certificate with a duration of at least two years, and the hospital files the Part 822 Outpatient and/or OTP Deeming Attestation Form. OASAS also keeps the right to make validation visits and other unannounced visits. A freestanding outpatient program that isn’t operated by a general hospital can’t use this route, so confirm your organizational structure actually qualifies before building deemed status into your plan.

Medication-Assisted Treatment in Outpatient Settings

OASAS’s general rules in Part 800 (amended effective October 1, 2022) require every certified program to facilitate quick access to medication for addiction treatment, through direct provision, contracts with private prescribing professionals, or linkage agreements with other OASAS-certified programs. A program also can’t deny admission because someone takes, intends to obtain, or prefers a particular medication. For buprenorphine, the old federal X-waiver is gone: DEA told registrants in January 2023 that “all prescriptions for buprenorphine only require a standard DEA registration number,” and New York’s Acting Commissioner of Health advised the same month that nothing in the Public Health Law or its regulations should be read to contradict that change. Section 800.6 still mentions the DATA 2000 waiver, which in our reading is now a dead reference. Your policies should spell out which of those three access routes your clients will actually use, so an outpatient program can offer buprenorphine without becoming an opioid treatment program.

Setting Up a Ketamine Practice in New York

New York has no ketamine clinic statute or rule. The licensing line below comes from the Public Health Law and DOH’s Article 28 criteria, and applying them to a ketamine practice is our interpretation.

As we read the rules, a practice giving ketamine for depression isn’t an OASAS program. Ketamine has no FDA approval for any substance use disorder, and Part 800 defines “approved medication” as medication approved for treating substance use disorder (§ 800.4(c)), so ketamine sits outside the medication framework a Part 822 program works under. If a Part 822 program wanted to bring it in house anyway, § 810.1 requires the commissioner’s prior approval before a provider offers a service, and we’d treat that as a conversation for the Regional Office first. Most operators keep it separate.

Private Practice or Article 28 Clinic

The real licensing question is whether DOH would see your practice as a diagnostic and treatment center. Public Health Law § 2801(1) counts a “diagnostic center” and “treatment center” as hospitals for Article 28 purposes, and 10 NYCRR 600.8 sets out how DOH separates those from private practice. Services delivered through a business corporation other than a professional service corporation fall on the Article 28 side. Describing the practice to the public as a “center” or “clinic,” or by any name other than the name of one or more of the practitioners, is prima facie evidence of a diagnostic or treatment center. DOH also looks at whether patients contact the facility rather than the physician, and whether the facility sets the bills, collects payment and decides how income is distributed. A practice organized as a physicians’ professional entity, known by its physicians’ names and billing in their names should stay on the private-practice side. A ketamine brand on the door and the lease can push the same practice toward an Article 28 establishment application.

Ownership, MSO Fees and Nurse Practitioners

New York’s corporate practice rule is firm. Business Corporation Law § 1507 lets a professional service corporation issue shares “only to individuals who are authorized by law to practice in this state,” and shares issued in violation “shall be void.” In State Farm v. Mallela (2005), the Court of Appeals said the licensing requirements “prohibit nonphysicians from owning or controlling medical service corporations” and let insurers withhold no-fault payments from medical corporations that nonphysicians secretly controlled. So the clinic is physician-owned, and a lay investor’s role runs through a management services organization.

The Education Law shapes what that MSO can charge. Under § 6530(19), it is professional misconduct for a physician to let anyone share in fees for professional services, including any arrangement where payment for space, facilities, equipment or personnel “constitutes a percentage of, or is otherwise dependent upon, the income or receipts” of the practice. A flat fee set at fair value is the workable structure, and a percentage-of-collections management fee is the one to avoid. Section 6530(18) separately bars paying or receiving any fee “for the referral of a patient,” which matters if an SUD program, a therapist group or an affiliated MSO is sending patients your way.

Nurse practitioners can prescribe in New York (Education Law § 6902(3)), but one with 3,600 practice hours or fewer works under a written practice agreement with a collaborating physician. Under the version of § 6902(3)(b) in force until July 1, 2030, an NP past 3,600 hours isn’t held to that requirement. As we read § 1507 and Mallela, an NP can’t hold shares in a physician’s professional corporation, so inside a physician practice the NP works as an employee or contractor. A practice owned by nurse practitioners themselves is a separate structure we don’t cover here.

Drug Rules for the Practice

Ketamine is Schedule III (21 CFR 1308.13(c)(7)), and a separate DEA registration is required at each location where it is stored and given (21 CFR 1301.12). Under Public Health Law § 3343-a, a practitioner has to check the prescription monitoring registry before prescribing or dispensing a Schedule II, III or IV drug, but not when administering it, so in-office doses don’t trigger a lookup and take-home prescriptions do. Spravato requires a REMS-certified setting and at least 2 hours of monitoring after each dose under its FDA labeling. How an OASAS inpatient program starts ketamine and hands patients to a practice like this one is covered in the ketamine section of New York Drug and Alcohol Inpatient Treatment Licensing.

Staffing an Outpatient Program

Most outpatient programs we see are built around a clinical director plus counselors who hold, or are working toward, the OASAS CASAC credential, with NYSED-licensed professionals filling some roles. The CASAC tiers are where the cost lever sits. Many programs hire CASAC-Trainees or CASAC-Provisionals who are logging the 6,000 hours of supervised work experience the full CASAC requires, instead of filling every counseling seat with a fully credentialed counselor. Two limits shape that plan. OASAS’s 2022 supervision standards call for weekly clinical supervision of trainees by a CASAC Advanced or Master level counselor or a NYSED-licensed QHP, and the CASAC-T and CASAC-P are temporary certificates that expire and can’t be renewed.

Budget $220,000 to $310,000 a year in clinical payroll for a lean outpatient setup (one clinical director plus two or three counselors), which tracks a statewide counselor median of $59,450, a touch over the $59,350 national figure. Most New York outpatient programs never pay that number in full, and structured supervision is why. Trainee and provisional counselors cost less while they log hours under a qualified director, and they come out the other end with a clear route to the full credential. We map the actual staffing plan after your service mix is settled.

How to Submit Your OASAS Application

The first move is Prior Consultation with your OASAS Regional Office and Local Governmental Unit. With a recommendation to proceed in hand, upload the completed Part 822 application through the NYSE-CON system. OASAS sends application problems to its Bureau of Certification at Certification@oasas.ny.gov, and its contact page lists a certification phone line of (518) 485-2250. The main office is at 1450 Western Avenue, Albany, NY 12203-3526, (518) 473-3460. The steps are laid out on OASAS’s program certification page. If you’re pursuing deemed status as a hospital-operated program, confirm the Deeming Attestation Form requirement with the Bureau directly.

What Slows Down an Outpatient Application

In our work with New York applicants, two issues explain most of the delays. The most common one isn’t OASAS’s own review speed. It’s applicants assuming a hospital affiliation isn’t necessary to pursue deemed status, then discovering the eligibility requirement late. Close behind it is treating county coordination as a formality just because the outpatient footprint is modest.

Frequently Asked Questions

Confirming whether your New York program qualifies for deemed status? Reach out here.

Sources

• OASAS: Program Certification (checked October 7, 2026)
• OASAS: Contact Us (checked October 7, 2026)
• 14 NYCRR § 810.1 (Justia mirror): Prior approval (checked October 7, 2026)
• 14 NYCRR § 822.3 (Justia mirror): Part 822 applicability (checked October 7, 2026)
• New York Mental Hygiene Law § 32.14: Compliance with operational standards by general hospitals (checked October 7, 2026)
• OASAS: Deeming Initiative, Outpatient and Opioid Treatment Programs (checked October 7, 2026)
• OASAS: Deeming announcement to Article 28 hospitals, January 2019 (checked October 7, 2026)
• OASAS: General Provisions (Part 800) (checked October 7, 2026)
• DEA Diversion Control Division: Dear Registrant letter, January 12, 2023 (checked October 7, 2026)
• NYS Department of Health: Commissioner letter on the MAT Act, January 20, 2023 (checked October 7, 2026)
• OASAS: CASAC credential (checked October 7, 2026)
• OASAS: Administrative and Clinical Supervision Definitions and Minimum Requirements (June 2022) (checked October 7, 2026)
• OASAS: Integrated Outpatient Services (Part 825) (checked October 7, 2026)
• New York Mental Hygiene Law § 36.08: Single license for integrated behavioral health services (checked October 7, 2026)
• NY Senate: S3051-B, signed as Chapter 60 of 2026 (checked October 7, 2026)
• OASAS: Part 800 General Provisions, § 800.4(c) (checked October 9, 2026)
• NY Public Health Law § 2801 (public.law mirror of the Senate text): Article 28 definitions (checked October 9, 2026)
• 10 NYCRR 600.8 (Justia mirror): Criteria for a diagnostic or treatment center (checked October 9, 2026)
• NY Business Corporation Law § 1507: Issuance of shares; State Farm Mut. Auto. Ins. Co. v Mallela, 4 NY3d 313 (2005): opinion (checked October 9, 2026)
• NY Education Law § 6530: Definitions of professional misconduct and § 6902 (public.law mirror): Nurse practitioner practice (checked October 9, 2026)
• 21 CFR 1308.13(c)(7) and 1301.12 (Cornell LII mirror): Ketamine in Schedule III and Separate registration for each location (checked October 9, 2026)
• NY Public Health Law § 3343-a (public.law mirror of the Senate text): Prescription monitoring program registry (checked October 9, 2026)
• FDA: SPRAVATO prescribing information and Medication Guide, revised 09/2026 (checked October 9, 2026)