Texas Drug and Alcohol Inpatient Licensing: CDTF Requirements

Author: A. Ant, CADC-II, Licensing & Accreditation Expert

Apply now: HHSC Chemical Dependency Treatment Facility Page (Form 3207) | Questions: CDTF-NTP_Licensing@hhs.texas.gov or (512) 438-4328

Texas Drug and Alcohol Inpatient Licensing: CDTF Requirements

Residential substance use treatment in Texas runs through a single, well-defined license (the Chemical Dependency Treatment Facility, or CDTF, license), but the details inside that license catch operators off guard more often than the license requirement itself does.

One license, and it doesn’t cover anything else

Straight from HHSC’s own rule, so you don’t have to dig through the statute yourself. HHSC licenses CDTFs under Texas Health and Safety Code Chapter 464 and 26 TAC Chapter 564, rules that moved from the old 25 TAC Chapter 448 in an administrative transfer in 2024, so if you’re working from older reference material, confirm you’re looking at the current chapter. HHSC states this plainly: a CDTF license is for CDTF licensure only, and holding one doesn’t satisfy any other licensure or authorization requirement you might separately need. It’s non-transferable and tied to a specific physical location, so buying an existing facility doesn’t transfer the seller’s license to you.

The application clock runs both ways

Once you submit, HHSC holds your application open for six months under 26 TAC § 564.403(f). If you haven’t demonstrated compliance with all applicable requirements by then, HHSC denies it, and you’re required to wait six months after a denial before reapplying. That six-month window isn’t generous; incomplete documentation or an unready physical plant can eat most of it before you realize how little time is left.

Accreditation can lighten your renewal burden

This is the part most CDTF guides leave out entirely. Texas Health and Safety Code § 464.0055 gives CDTFs a real option most operators don’t know to ask about: HHSC may waive the inspection normally required before renewing a license if you submit a current accreditation review from CARF, Joint Commission, or another nationally recognized accrediting organization instead. This applies to renewal, not your initial licensure inspection, and it doesn’t mean accreditation is required, only that it can genuinely reduce duplicate review once you have it.

Telehealth is a real option for part of your program

A relatively recent addition, HSC § 462.015, allows a licensed CDTF to provide outpatient chemical dependency treatment services to adult and adolescent clients using telecommunications or information technology, under specific conditions. If your residential program also runs a step-down outpatient component, this is worth building into your service design rather than assuming everything has to happen in person.

Medication-assisted treatment

Residential CDTFs should have a genuine, working pathway to medication-assisted treatment: buprenorphine, naltrexone, or an actual coordination relationship with a licensed opioid treatment program for methadone access, named specifically rather than a referral that goes nowhere. Toxicology Associates operates certified OTP locations across the state, including Houston, Corpus Christi, and La Marque, and Texas surveyors increasingly expect that kind of named partner documented as part of a program’s actual clinical capability, not just its stated philosophy.

Staffing a Residential CDTF

A residential CDTF needs a clinical director, enough LCDC-credentialed counselors to match your population’s acuity, and round-the-clock direct-care and nursing coverage. Texas LCDCs earn a median of about $48,000 to $49,000 a year statewide, with entry-level counselors around $35,000 and experienced clinical or supervisory staff at $70,000 or more, so a residential program with a clinical director, several counselors, and 24-hour direct-care staff commonly runs well past $400,000 a year in payroll before nursing coverage. That’s a real number, and most Texas residential operators never actually carry the full weight of it. A clinical director supervising several Counselor Interns working toward their 4,000 supervised hours, at reduced wages in exchange for the hours their LCDC license requires, can cut clinical staffing costs by 40 to 60% compared to an all-LCDC roster, and pairing one RN with several LVNs rather than staffing every shift with a registered nurse brings nursing costs down too. Once your census and level of care are confirmed, the actual staffing matrix follows.

How to Submit Your CDTF Application

HHSC’s Chemical Dependency Treatment Facility page has the initial licensure application, Form 3207, along with Form 3208’s applicant checklist. For CDTF licensing questions, contact CDTF-NTP_Licensing@hhs.texas.gov. For physical plant requirements and pre-licensure inspection scheduling specifically, the Substance Use Disorder Compliance Unit can also be reached at (512) 438-4328.

Frequently Asked Questions

Where This Fits In

This covers the CDTF side specifically. For the full Texas picture, residential, outpatient, mental health, and reinstatement, see Texas Behavioral Health Licensing.

This content is provided for general informational purposes only and should not be construed as medical, clinical, legal, financial, tax, accounting, insurance, licensing, accreditation, regulatory, billing, employment, or compliance advice. Requirements change often. Consult qualified professionals for guidance specific to your situation.

Working through a CDTF application in Texas?