Wyoming Drug and Alcohol Inpatient 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: Behavioral Health Division certification, filed online in the Behavioral Health Management System (BHMS), required before a residence can take court-ordered or referred clients | Questions: WDH certification program, wdh-certification@wyo.gov, (307) 777-5253 or toll free (800) 535-4006

As we read Wyoming law, there is no state license for a residential addiction program. The licensed health care facility types in W.S. 35-2-901(a)(x) run from ambulatory surgical centers to renal dialysis centers, and none of them is a substance use disorder treatment facility. What the state does have is a certification run by the Wyoming Department of Health (WDH), Behavioral Health Division (BHD), and for a residential house the real trigger is the courtroom. W.S. 9-2-2701(c) says courts “shall not refer individuals for substance abuse or related treatment to programs, providers or facilities which are not certified to provide those services for which the individual is referred.” Once a residential program wants those referrals, the BHD rules go a step further and require national accreditation, and only three accreditors qualify.

This guide covers adult residential addiction treatment in Wyoming, from Level 3.1 up through 3.7. Anyone planning a day program, court-referred assessments or an office ketamine practice will find those in Wyoming Drug and Alcohol Outpatient Treatment Licensing. Psychiatric hospitals, the one inpatient behavioral setting Wyoming does license, are in Wyoming Mental Health Inpatient Licensing, and the agency overview is on Wyoming Behavioral Health Licensing.

A Certification That Works as a Gate, Not a License

The statute text below comes from the official Wyoming Statutes title PDFs on wyoleg.gov and the rule text from WDH’s posted rule printouts. Our conclusion that no license exists for a freestanding program is our reading of what the facility list leaves out, not a WDH statement.

BHD certifies under W.S. 9-2-2701 and the Mental Health and Substance Use Disorder Services Rules, Chapters 1 through 5, 7 and 8, most of which took effect September 18, 2024. The rules are candid about their reach. Chapter 1 defines a “Provider” as “a provider of behavioral health services funded by the Department or a provider of substance use disorder services to persons referred or ordered to receive services by a court.” BHD’s certification page lists the same short set of reasons a program needs it, and assessments or treatment for court-ordered or referred clients is the one that matters for a private residential house. Taking state or Department of Corrections money for SUD services also requires certification, but that is a funding relationship that sits outside any license, and we don’t handle it.

So a private-pay residence with no court clients needs no BHD certification at all, in our reading. That doesn’t leave it with nothing to do. In our view a Wyoming residential program still needs, at a minimum:

• A business entity in good standing and whatever building, occupancy, zoning and fire approvals your city or county requires for the property (we did not research local codes, so ask the local planning office early)
• Clinicians licensed or certified by the Mental Health Professions Licensing Board, which describes Wyoming as “a Practice Act and Title Protection state”
• DEA registration plus a Wyoming controlled substance registration from the Board of Pharmacy for each location where controlled medications are dispensed (W.S. 35-7-1024(a))
• National accreditation, if court-ordered residents are part of the plan

Hospitals are the exception. The WDH Aging Division’s Healthcare Licensing and Surveys (HLS) licenses hospitals and psychiatric hospitals, and the BHD handbook itself sends providers with facility licensing questions to HLS. A residential addiction house that is not a hospital has no HLS category to apply under.

Court-Ordered Residents Require Accreditation From TJC, CARF or NIAHO

Chapter 2, Section 2(b) of the BHD rules is blunt: “If a substance use disorder residential treatment services provider provides services to court-ordered clients the provider must be nationally accredited for substance use disorder residential treatment services.” An outpatient program in the same position can choose between accreditation and the state’s own standards. A residential one cannot.

The accreditor list is narrower than most states use. Chapter 1, Section 3(a)(xx) defines national accreditation as accreditation “issued by The Joint Commission (TJC), the Commission on Accreditation of Rehabilitation Facilities (CARF), or National Integrated Accreditation for Healthcare Organizations (NIAHO).” COA does not appear. An operator expanding into Wyoming with a COA-accredited model would need a second accreditor before taking court referrals into residential care.

Accreditation also carries the state review. Under Chapter 2, Section 3(b), the Section 8 certification standards “are deemed satisfied” for an accredited provider, on the initial application and again at renewal. The price of that shortcut is paperwork flowing back to BHD. Section 4(b)(ii) requires an accredited provider to send the Department, within 30 calendar days of sending them to the accreditor, survey reports and “reports of major unusual incidents or sentinel events,” along with proof the accreditor accepted them, as requested by the Department.

Wyoming residential setting	State approval	Accreditation	Who decides
Private-pay residence, no court referrals	None found (our reading of W.S. 35-2-901(a)(x))	Optional	Local building and zoning offices, clinician boards
Residence taking court-ordered or referred clients	BHD certification, decided within 30 calendar days of a complete application	Required, TJC, CARF or NIAHO only	WDH Behavioral Health Division
Psychiatric hospital or hospital psychiatric unit	HLS license, $1,000 fee, one-year term running July 1 to June 30	Optional, but an accredited facility renews without further state inspection (W.S. 35-2-907(a))	WDH Healthcare Licensing and Surveys

ASAM Levels and CARF’s Level of Care Certification

Wyoming leans on ASAM placement even though it licenses no residential level. A certified provider that is not accredited must have policies covering “Placement of clients in the appropriate level of care based on American Society of Addiction Medicine (ASAM) criteria” (Chapter 2, Section 9(b)(ix)), levels of care are reviewed at least every 90 days, and the rules incorporate the ASAM Criteria Fourth Edition by reference. BHD’s March 2026 certification handbook lists the services a provider selects in BHMS, and on the adult side that includes 3.1, 3.5, 3.7 Medically Managed Residential and 4.0. BHD’s new provider checklist says the fourth edition adult levels took effect July 1, 2026, so a policy manual still built around the third edition’s numbering is already out of date.

The level a Wyoming residence runs shows up in its BHMS service selections, if it is certified, and nowhere else the state controls. CARF’s ASAM Level of Care Certification is a separate way to document it. CARF says certification “is available for adult Levels of Care 3.1, 3.5, and 3.7,” which means adult residential care at those three levels and nothing else, and ASAM describes the program the same way. No Wyoming rule we read requires it, and nothing in either description reaches withdrawal management, so we would not present it as covering a 3.7 withdrawal management service. For a private-pay residence that holds no state certification at all, it may be the only outside confirmation of level a referral source can check, using the Certification filter in CARF’s provider search. That use is our suggestion, not a state requirement.

Certificate of Need Ended July 1, 2026

Wyoming repealed its old institutional health services review article (W.S. 35-2-201 to 214) in 1985 and 1987, and the last piece of bed control went this year. 2025 HB0289, titled “Certificate of need repeal-3” and signed March 3, 2025 as Chapter 102, says “This act repeals bed expansion limitations for nursing care facilities and hospitals,” and its digest shows a delayed effective date of July 1, 2026. Those limits never applied to a residential addiction house, which isn’t a licensed health care facility in the first place. The plan review in W.S. 35-2-906(a) still applies to licensed facilities such as hospitals, and it is now limited to health care and life safety.

Medication for Opioid Use Disorder in a Wyoming Residence

The BHD rules define medication assisted treatment as “the use of medications, excluding those used for detoxification, which are used in combination with counseling and behavioral therapies,” but we found no rule that requires a residential or outpatient program to offer it. For a certified provider that is not accredited, Chapter 2, Section 11(c)(xv)(E) expects case records to show “documentation of collaboration and attempts to collaborate with the MAT practitioner,” so the clinical team and whoever prescribes need a working relationship that leaves a paper trail.

Buprenorphine is the easiest medication to bring in house. DEA’s January 12, 2023 letter told registrants that “all prescriptions for buprenorphine only require a standard DEA registration number,” and Wyoming adds its own controlled substance registration from the Board of Pharmacy for practitioners who dispense, renewed every two years. Methadone is a different track. When a resident’s methadone comes from an opioid treatment program, put dose verification, transport and the handling of missed doses into a signed agreement with that OTP before admission.

Ketamine for Residents in a State Without a Residential License

Ketamine doesn’t appear anywhere in the Wyoming statutes, BHD rules or board opinions we searched. The statements about registration and monitoring come from the statutes and FDA documents cited, and the conclusions about what a residence must do are our interpretation.

Since nothing is licensed at the facility level, a residence has no license to amend when it adds ketamine. A private-pay residence that starts ketamine for a resident’s co-occurring depression or PTSD answers to its prescriber’s licenses and registrations, not to a facility rule. A BHD-certified residence is in a similar spot. The Add a Level of Care Service form BHD uses covers ASAM services, and we found no rule that requires notice to BHD before adding a medication. Our practice would be a short letter to BHD and to the accreditor ahead of the first dose, because an accredited program sends BHD its accreditor reports under Section 4(b)(ii) when the Department asks, and a ketamine incident would show up there.

The Nursing Board and Who Can Prescribe

Ketamine isn’t among the titles on the Wyoming State Board of Nursing’s advisory opinion list. The list does carry opinions on “Moderate Sedation & Pain Management” and on infusion therapy, which we did not read, so the RN’s role in giving ketamine should be checked with the board’s practice staff at wsbn.practice@wyo.gov before you write the protocol. On the prescriber side, the statutory definition of APRN practice in W.S. 33-21-120(a)(i)(A) says an APRN “May prescribe, administer, dispense or provide nonprescriptive and prescriptive medications including prepackaged medications, except schedule I drugs,” and that definition names no collaborating physician. We read it as letting an APRN order ketamine, a Schedule III drug, without physician sign-off, though the board is the place to confirm it.

Registrations, the PDMP and Spravato

Ketamine sits in federal Schedule III (21 CFR 1308.13(c)(7)). Wyoming’s state registration, which a practitioner dispensing controlled substances must “obtain every two (2) years, on or before July 1,” from the Board of Pharmacy, is issued separately for each location (W.S. 35-7-1023 and 35-7-1024). Under W.S. 35-7-1060(b), a prescriber “shall search the prescription tracking program for prior prescriptions issued to the patient before first issuing the prescription” for a Schedule II to V drug. Whether a dose given on site, rather than prescribed, has to be reported is something the statute doesn’t say and we did not resolve, so get the Board of Pharmacy’s answer before building a dosing log around either assumption. Spravato carries federal conditions of its own. Its FDA labeling says “SPRAVATO can only be administered at healthcare settings certified in the SPRAVATO REMS program,” and the patient is monitored for at least 2 hours after each dose.

Who Should Not Be First in Line

Every indication on the FDA label for Ketalar is an anesthesia use. Nothing there touches addiction, so ketamine can’t count as MOUD or replace a resident’s buprenorphine or methadone. We would look first at residents whose withdrawal ended weeks ago, whom the clinical team has watched long enough to read, and whose depression or trauma symptoms have held on through standard care. Past misuse of ketamine, PCP or similar drugs comes close to ruling a resident out in our view. Screening belongs to the prescribing physician or APRN.

Handing the Series to an Outpatient Clinic

A course of ketamine often still has sessions left when a resident’s discharge date arrives. Wyoming’s ownership picture is open but not settled. We searched the Medical Practice Act and found no corporate practice bar in it, and Title 17, Chapter 3 lets licensees form professional corporations whose shareholders must all hold the license the corporation practices under. We did not search Wyoming case law on lay ownership, so we treat the question as unsettled and plan around a professional corporation owned by the physician or APRN, which keeps every treatment decision, alongside a separate company that rents the space, employs the front desk and sends the bills. Office-based clinics and how the two entities split the work are covered in the ketamine section of Wyoming Drug and Alcohol Outpatient Treatment Licensing.

A written legal opinion should come before the first patient moves between the residence and the clinic. 18 U.S.C. 220, the Eliminating Kickbacks in Recovery Act, reaches recovery homes and any clinical treatment facility that operates “pursuant to licensure or certification under State law,” for services a health care benefit program covers, and each occurrence can draw a fine of as much as $200,000, a prison term of as long as 10 years, or both. In our reading a BHD-certified residence fits that wording. Whether an uncertified private-pay residence does is less clear in a state with no license, and a referral deal should not rest on that gap. Our keyword search of Wyoming’s health, professions and corporations titles found no state patient brokering statute, but we did not search the criminal code.

Who Works in a Wyoming Residence

The BHD rules don’t require a medical director, a nursing ratio or awake overnight staff for a residential SUD program, at least in the chapters we read in full. They do define residential treatment as a service that “operates twenty-four (24) hours per day, seven (7) days per week,” and an accredited program follows its accreditor’s staffing standards. A certified program that is not accredited needs clinical oversight by a qualified clinical supervisor, at least one contact a month (Chapter 2, Section 10(b)).

Wyoming pays its counselors a few thousand dollars more than the country as a whole. The BLS median for substance abuse, behavioral disorder, and mental health counselors in Wyoming is $62,980 (OEWS, May 2025), with the 25th percentile at $46,300 and the 75th at $80,310, against a national median of $59,350. Seven clinical salaries (a director and six counselors) at that median add up to roughly $440,860 a year (7 x $62,980, our estimate), and overnight technicians, nursing, administration and benefits all sit on top of that. Few Wyoming residences open with seven fully licensed clinicians, because the state’s three-tier addictions credential gives them a cheaper way to start. W.S. 33-38-102 ties the Certified Addictions Practitioner (CAP) to “the supervision of a qualified clinical supervisor licensed in the state of Wyoming” and puts the Certified Addictions Practitioner Assistant (CAPA) under supervision too, while the statute attaches no such condition to the Licensed Addictions Therapist (LAT). The CAPA credential takes 270 contact hours of education and training, and one route to CAP adds 2,000 hours of supervised work as a CAPA (W.S. 33-38-106). Let an LAT supervise CAPs and CAPAs while they bank those hours, pay each person at the rate of the tier they hold, and the clinical wage line typically lands 40 to 60 percent below an all-LAT roster. If the house provides medical services, a single RN directing several LPNs is the cheaper nursing model. How many beds you fill and which ASAM levels you run decide the schedule from there.

How to Submit Your Wyoming Certification Application

A residence that will take court-ordered or referred clients applies through BHD’s new provider certification process:

1. Earn national accreditation for SUD residential treatment from TJC, CARF or NIAHO. For a residence taking court-ordered clients this comes first.
2. Gather the items on the New Provider Certification Application Checklist (08.2026): proof of business authority (a local business license where one is required, or a state entity document such as an LLC Certificate of Organization), articles or bylaws, the Statement of Disclosure and Release of Information forms, a liability insurance certificate, staff licenses and a Policy and Procedure Manual meeting Chapter 2, Section 9(b). Accredited providers add their latest survey report, the award letter and any reports of major unusual incidents or sentinel events.
3. File the application in BHMS, selecting the ASAM residential levels you will run. An application left incomplete for 90 calendar days is rejected.
4. Expect a decision within 30 calendar days of a complete application (Chapter 2, Section 4(a)(ii)). The review may include an on-site inspection and a check with your accreditor.

We found no certification fee in Chapter 2 or the handbook. A new provider receives a provisional six-month certification first, then renewal for six months to three years, and renewal applications are due at least 30 calendar days before expiration. Certification is non-transferable, so a sale ends it. Questions go to the certification program at wdh-certification@wyo.gov or (307) 777-5253. Accreditation sets the pace here. Counting from a signed lease, our own planning figure for a residence that must be accredited before certification is 9 to 15 months, and WDH has published no overall timeline to compare it with.

Where Wyoming Residential Plans Go Wrong

The most common mistake we expect is treating BHD certification as optional and then signing a contract with a drug court or probation office. Without certification the court cannot send anyone, and without accreditation the residence cannot get certified for court-ordered residential clients. Close behind is choosing COA because it worked in another state. A third is a policy manual that still uses third edition ASAM numbering after July 1, 2026. Out-of-state operators also tend to look for an HLS application for the residence itself, and there isn’t one.

Frequently Asked Questions

Planning a Wyoming residence that will take drug court referrals? Start the conversation here.

Sources

• Wyoming Statutes, Title 35 (35-2-901, 35-2-904, 35-2-906, 35-2-907, 35-7-1023, 35-7-1024, 35-7-1060): Title 35, Public Health and Safety (PDF) (checked October 20, 2026)
• Wyoming Statutes, Title 9 (9-2-2701): Title 9, Administration of the Government (PDF) (checked October 20, 2026)
• Wyoming Statutes, Title 33 (33-21-120, 33-38-102, 33-38-106): Title 33, Professions and Occupations (PDF) (checked October 20, 2026)
• Wyoming Statutes, Title 17 (17-3-101 to 17-3-104): Title 17, Corporations (PDF) (checked October 20, 2026)
• WDH Mental Health and Substance Use Disorder Services Rules, Chapter 1: General Provisions (PDF) (checked October 20, 2026)
• WDH Mental Health and Substance Use Disorder Services Rules, Chapter 2: Behavioral Health Service Provider Certification (PDF) (checked October 20, 2026)
• WDH Behavioral Health Division: Rules and Regulations (checked October 20, 2026)
• WDH Behavioral Health Division: Provider Certification (checked October 20, 2026)
• WDH Behavioral Health Division: New Provider Certification (checked October 20, 2026)
• WDH Behavioral Health Division: New Provider Certification Application Checklist, 08.2026 (PDF) (checked October 20, 2026)
• WDH Behavioral Health Division: MHSA Certification Program Handbook, March 2026 (PDF) (checked October 20, 2026)
• WDH Aging Division: Healthcare Licensing and Surveys (checked October 20, 2026)
• Wyoming Legislature, 2025 HB0289: Certificate of need repeal-3, bill summary (PDF) (checked October 20, 2026)
• Wyoming Legislature, 2025 HB0289: Bill digest, signed March 3, 2025 (PDF) (checked October 20, 2026)
• Wyoming Mental Health Professions Licensing Board: Board home page (checked October 20, 2026)
• Wyoming State Board of Nursing: Practice and advisory opinions (checked October 20, 2026)
• DEA Diversion Control Division: Dear Registrant letter, January 12, 2023 (PDF) (checked October 20, 2026)
• 21 CFR 1308.13(c)(7), via Cornell LII: Schedule III, ketamine (checked October 20, 2026)
• U.S. FDA: SPRAVATO prescribing information, REMS and monitoring (PDF) (checked October 20, 2026)
• U.S. FDA: KETALAR prescribing information, indications (PDF) (checked October 20, 2026)
• 18 U.S.C. 220, via Cornell LII: Illegal remunerations for referrals to recovery homes, clinical treatment facilities, and laboratories (checked October 20, 2026)
• CARF: ASAM Level of Care Certification (checked October 20, 2026)
• ASAM: Level of Care Certification (checked October 20, 2026)
• CARF: Find a Provider (Certification filter) (checked October 20, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: Wyoming estimates (checked October 20, 2026)
• U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: National estimates (checked October 20, 2026)