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New York Mental Health Outpatient Licensing

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A. Ant, CADC-II

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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: OMH Bureau of Inspection and Certification | Questions: contact the OMH Field Office serving your region

Outpatient mental health treatment in New York is licensed by the Office of Mental Health (OMH) under Article 31 of the Mental Hygiene Law, which bars anyone from running a covered program without an OMH operating certificate. OMH now calls the licensed clinic a Part 599 Mental Health Outpatient Treatment and Rehabilitative Service (MHOTRS) program. Addiction treatment is certified by a different agency, OASAS, under Article 32. So a program that wants both kinds of outpatient care usually ends up dealing with both agencies, although New York does have an integrated route that puts both under one license at a single site (covered further down).

Licensing Outpatient Mental Health Care

New providers get licensed through OMH’s Prior Approval Review (PAR). The minimum standards for anyone seeking an OMH operating certificate sit in 14 NYCRR Part 551, and the clinic’s own program rules are in Part 599. Before you file, OMH expects you to meet with your county’s Director of Community Services and with the OMH Field Office, which tells you which type of PAR application you need and what documents go with it. After filing, the PAR Manager routes the application to the Local Governmental Unit (LGU) and OMH staff for comments, and proposals that go before the Behavioral Health Services Advisory Council get a recommendation from its Project Review Committee before the Commissioner decides. Your first operating certificate is issued for twelve months.

If you’ve been through OASAS’s Part 810 process for an SUD program, the outline will feel familiar, since that rule also sends full-review applications to the LGU and then to the same advisory council. The reviews themselves are separate, though. OMH looks at your OMH application and OASAS looks at its own.

Deemed Status Is Limited to General Hospitals

Accreditation can substitute for part of OMH’s oversight, but only if your outpatient program belongs to a general hospital. Mental Hygiene Law § 31.08 lets OMH treat a general hospital’s accreditation by The Joint Commission (or another accreditor with CMS deeming authority that the commissioner finds sufficient) as meeting the § 31.07 inspection requirements for the mental health services it runs under an OMH operating certificate. If the hospital meets the statute’s conditions, the commissioner can also excuse it from the annual inspection. OMH still keeps the right to inspect at any time. The law doesn’t split inpatient from outpatient, so a hospital-run clinic can qualify. OASAS has a parallel provision for hospital programs in § 32.14.

A freestanding outpatient clinic gets nothing from either section. We also couldn’t find an OMH page explaining how it applies § 31.08 in practice today, so a hospital looking at this should raise it with its Field Office. Accreditation from The Joint Commission or CARF still carries weight with payers and referral partners for a non-hospital clinic. OMH will keep inspecting on its usual schedule anyway.

Can an MHOTRS Clinic Offer Ketamine or Spravato?

OMH’s MHOTRS guidance defines psychotropic medication treatment as “using pharmacologic agents to treat underlying psychiatric illness,” delivered by a psychiatrist or a psychiatric nurse practitioner, or by a psychiatry-qualified physician assistant under a psychiatrist’s supervision if OMH approves. Ketamine, esketamine and Spravato don’t appear anywhere in that guidance. Our reading is that a Spravato session or a ketamine dose ordered by the clinic’s psychiatrist is a form of that service, but OMH hasn’t said so. The guidance also notes that some optional MHOTRS services “still require OMH approval through an Administrative Action,” so raise it with your Field Office before the first dose and keep their answer in writing.

Ketamine and its isomers are federal Schedule III (21 CFR 1308.13(c)(7)), and DEA wants a separate registration for each place the drug is dispensed (21 CFR 1301.12(a)). On the state side, the Bureau of Narcotic Enforcement’s license packet (DOH-4330) ties its Class 3 institutional dispenser license to an Article 28 operating certificate “or equivalent State Agency operating authority” and never mentions OMH clinics. We couldn’t tell from it whether an Article 31 clinic holding its own ketamine stock needs a BNE license, so ask BNE at bnelicensing@health.ny.gov before you order.

Schedule II, III and IV drugs all fall inside the registry duty in Public Health Law § 3343-a, for prescribing and dispensing alike. Administration is carved out (“a practitioner administering a controlled substance”), and our reading is that a psychiatrist dosing a patient in the treatment room fits that carve-out, while a ketamine script filled at an outside pharmacy still calls for the registry check. For a psychiatric NP, the written practice agreement and protocols in Education Law § 6902(3)(a) govern prescribing through the first 3,600 hours of practice. Past that mark, the current text of § 6902(3)(b), in effect until July 1, 2030, no longer requires them.

Spravato brings its own conditions. Only a healthcare setting certified in the Spravato REMS can administer it, each patient sprays the dose in the clinic while a provider watches, and the Medication Guide has the provider monitor the patient for 2 hours or more. Plan staffing and a quiet room for that window.

An owner who wants a ketamine practice outside the MHOTRS license, especially one marketed under a clinic name, should read the ketamine section of New York Drug and Alcohol Outpatient Treatment Licensing, which covers who may own a New York medical practice and when DOH treats a private practice as a clinic that needs its own approval.

Staffing and Credentialing

Mental health clinicians in New York hold licenses from the State Education Department, while addiction counselors earn the CASAC credential from OASAS. Part 599 defines a clinic’s professional staff as practitioners with a license or limited permit from the Education Department. The list covers licensed clinical social workers, licensed master social workers, licensed mental health counselors, psychologists, marriage and family therapists, nurses, nurse practitioners, physicians and psychiatrists, among others. Your staffing plan also has to show enough psychiatric and medical coverage for the people you serve. If you plan to add SUD services later, our advice is to hire with both agencies’ staffing rules in mind from the start.

BLS OEWS figures for May 2025 put the statewide median for New York counselors and mental health clinicians at $59,450, a little over the national median, with pay spanning roughly $42,410 at the 10th percentile to $90,590 at the top. For a small mental health clinic (a clinical director and two or three licensed clinicians), clinical payroll commonly lands between $240,000 and $330,000 a year. Staffing every role at the independent level isn’t actually necessary to stay compliant here. Part 599 counts a licensed master social worker as a licensed practitioner when an LCSW, licensed psychologist or psychiatrist employed by the agency supervises them, and limited permit holders work under supervision while they finish licensure. Many programs pair a fully licensed clinician as director with associate-level clinicians working toward independent licensure under that director’s supervision, which trims payroll and gives those clinicians a real way to advance. The exact headcount depends on your service mix and expected census, so we set it once those are known.

How to Submit Your OMH Application

Every PAR application is filed through OMH’s Mental Health Provider Data Exchange (MHPD) system. Talk to your Field Office before you upload anything. OMH has five of them (Central New York, Hudson River, Long Island, New York City and Western New York), listed with the counties each one serves in the Field Office directory, and their licensing staff give technical assistance while your application is in review. They also handle the pre-occupancy site visit before you open. PAR questions go to par@omh.ny.gov, and broader certification questions go to OMH’s Bureau of Inspection and Certification at certification@omh.ny.gov.

Offering Mental Health and SUD Care at One Site

The route that exists today is Integrated Outpatient Services. Under OMH’s rule, 14 NYCRR Part 598 (OASAS has a matching Part 825), a provider holding licenses or certificates from at least two of the three participating agencies (OMH, OASAS and the Department of Health) can be approved to deliver integrated care at a single outpatient host site. When an Article 31 clinic is the host, OMH monitors the site, and OMH describes the arrangement as cross-agency services under a single license with one oversight agency and one recertification survey. Mental Hygiene Law § 32.05(b) supports this from the OASAS side: an Article 31 provider authorized for integrated services doesn’t need its own OASAS operating certificate for them. The application goes to the agency that licenses the host site. The entry requirement is the catch. A brand-new operator with only an OMH clinic license can’t use this route until it also holds an OASAS or DOH license somewhere in its network.

A second option is on the books but may not be live yet. Under Mental Hygiene Law § 36.08, which Chapter 60 of the Laws of 2026 put on the books, OMH and OASAS may jointly create a single license for integrated behavioral health services. Its start date hinges on two events, and the later one controls: OMH and OASAS approving and certifying reimbursement rates for those services, and the related § 36.06(d) regulations taking effect. We haven’t confirmed that has happened, so ask both agencies before you plan around it.

Common Sequencing Mistakes

Two mistakes cause most of the friction on co-occurring applications. The most common issue is assuming an OMH clinic license covers SUD treatment too. It doesn’t, and unless the site has been approved for Integrated Outpatient Services, OMH and OASAS each review their own piece. Next comes assuming the county mainly cares about SUD programs and leaving too little time for it on the mental health side. OMH requires the pre-filing meeting with your Director of Community Services and sends your PAR to the LGU for review, so the county is involved on the mental health side as well.

Frequently Asked Questions

How long does outpatient mental health licensing take in New York?

Our working estimate is 8 to 14 months from the start of planning until OMH issues the operating certificate, with LGU review and hiring usually setting the pace. That figure comes from our own project experience. OMH’s guidance just says final approval may take up to several months and depends on the program type, the applicant’s experience and how complex the application is.

Do I need different licenses to offer both mental health and SUD outpatient services in New York?

Usually, yes. OMH licenses mental health clinics under Article 31 and OASAS certifies SUD programs under Article 32. A provider already licensed by two of the participating agencies (OMH, OASAS or the Department of Health) can apply to run both kinds of care at one host site under a single license with one survey. A 2026 law, Mental Hygiene Law section 36.08, also lets OMH and OASAS create a joint single license, but it starts only after reimbursement rates for integrated services are approved and certified and the related section 36.06(d) regulations take effect, and we haven’t confirmed that has happened yet.

Can telehealth satisfy New York’s outpatient mental health licensing requirements?

Telehealth doesn’t replace the Article 31 operating certificate. OMH has its own telehealth rule, 14 NYCRR Part 596, first introduced in 2015 and amended in 2016, 2019 and 2022, with the 2022 changes allowing audio-only services. OMH also publishes Telehealth Services Guidance and a telehealth attestation form for licensed programs. If you want a mostly virtual model, ask OMH at telehealth@omh.ny.gov how those rules apply before you build it.

Running a New York program that treats both populations and needs both agencies sorted out? Reach out here.

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