How to start a behavioral health clinic in Florida

Florida requires a DCF Substance Use Disorder provider license, issued per licensable service component (e.g., Outpatient Treatment, Intensive Outpatient Treatment, Day or Night Treatment) from Florida Department of Children and Families — Office of Substance Abuse and Mental Health, Substance Use Disorder Licensing and Regulation to operate a behavioral health clinic. Fee: Per service component (65D-30.0035, as amended 2025-10-16): Outpatient Treatment $250 (publicly funded) / $300 (privately funded); Intensive Outpatient Treatment $250 / $300; Day or Night Treatment $250 / $300; Outpatient Detoxification $325 / $375; Methadone MAT $350 / $400; General Intervention $200 / $250. Fees must be paid in full before the application is processed.

License required

Yes

License

DCF Substance Use Disorder provider license, issued per licensable service component (e.g., Outpatient Treatment, Intensive Outpatient Treatment, Day or Night Treatment)

Issuing agency

Florida Department of Children and Families — Office of Substance Abuse and Mental Health, Substance Use Disorder Licensing and Regulation

Fee

Per service component (65D-30.0035, as amended 2025-10-16): Outpatient Treatment $250 (publicly funded) / $300 (privately funded); Intensive Outpatient Treatment $250 / $300; Day or Night Treatment $250 / $300; Outpatient Detoxification $325 / $375; Methadone MAT $350 / $400; General Intervention $200 / $250. Fees must be paid in full before the application is processed.

Renewal

Renewal applications are due at least 60 days before the current license expires; late applications incur a $100 late fee per licensable service component.

Accreditation

Optional; DCF recognizes CARF, COA, Green Apple Accreditation Commission and The Joint Commission, and has a separate renewal checklist for accredited providers.

Regulation

Chapter 397, F.S.; Chapter 65D-30, F.A.C. (fees at 65D-30.0035)

1. Review Chapter 397, F.S., and Chapter 65D-30, F.A.C., and the DCF new-application checklist
2. Choose the licensable service components (e.g., outpatient, intensive outpatient)
3. Complete the Application for Licensure, Attestation of Good Moral Character and HIV/AIDS education confirmation
4. Pay the component fees and submit electronically in DCF's LEADS system (or on paper with a check to the regional licensure office)
5. Pass DCF review and inspection, then renew at least 60 days before expiration

Program

Florida Medicaid (Agency for Health Care Administration)

Enrollment portal

Florida Medicaid Web Portal (FLMMIS) — Enrollment Wizard

Fiscal agent

Gainwell Technologies (Florida Medicaid Web Portal / FLMMIS)

Application fee

Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Florida also requires Level 2 background screening (fingerprint-based, under s. 408.809, F.S.) as part of enrollment and revalidation. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

AHCA assigns each provider type a limited, moderate or high risk level under 42 CFR 455.450. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Florida calls revalidation 'renewal': AHCA re-enrolls every provider at least every five years, mailing a notice about 90 days before the provider agreement expires. Claims suspend if the online renewal is not finished by the expiration date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Florida Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Florida Agency for Health Care Administration (AHCA)

Services covered

• community nursing homes / skilled nursing facility beds
• hospice programs and hospice inpatient facilities
• intermediate care facilities for the developmentally disabled (ICF/DD)
• conversion from one type of covered facility to another

Florida certificate of need details →

State minimum wage

$15.00 an hour

Effective

2026-09-30

Scheduled increases

Stays $15.00 from 2026-09-30 through 2027-12-31; annual inflation adjustments resume with a September 2027 calculation that takes effect the following January 1.

Direct-care wage floor

The 2022-23 General Appropriations Act funded Medicaid fee schedule and managed care rate increases for the sole purpose of raising wages of Medicaid providers' direct care employees (including 1099 workers) to at least $15/hour.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Community/behavioral health agencies and mental health clinics — active organization NPIs (NPPES)

7,619 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

3,565,369 (as of Jun 1, 2026)

All Florida Behavioral health Medicaid rates, ranked →

• Familial Dysautonomia Waiver (1915(c))
• Developmental Disabilities Individual Budgeting Waiver (1915(c))
• Comprehensive Intellectual and Developmental Disabilities Managed Care Pilot Program (1915(c))
• Long-Term Care Waiver (1915(c))
• Model Waiver (1915(c))

Florida waivers and waiting lists →