How to start a behavioral health clinic in Louisiana

Louisiana requires a Behavioral Health Service (BHS) Provider license (covers mental health clinics, substance use/addiction treatment facilities and other BHS providers) from Louisiana Department of Health — Health Standards Section (HSS) to operate a behavioral health clinic. Fee: A non-refundable licensing fee set by statute must accompany the initial application packet; the amount is not printed in the rule.

License required

Yes

License

Behavioral Health Service (BHS) Provider license (covers mental health clinics, substance use/addiction treatment facilities and other BHS providers)

Issuing agency

Louisiana Department of Health — Health Standards Section (HSS)

Fee

A non-refundable licensing fee set by statute must accompany the initial application packet; the amount is not printed in the rule.

Renewal

Every year

Insurance and bonds

Proof of financial viability includes general liability insurance of at least $500,000 and professional liability insurance of at least $500,000 (or qualifying self-insurance; self-insured providers not in the Patient's Compensation Fund need $1 million per occurrence / $3 million aggregate), plus workers' compensation insurance.

Accreditation

Optional for licensure: after an initial license, LDH may grant deemed status, accepting accreditation from an LDH-authorized accreditation organization in place of on-site licensing surveys. Louisiana is in the 2026 cohort of the federal CCBHC Medicaid demonstration.

Survey and inspection

Announced on-site initial licensing survey before the license is issued; deemed-status providers may be exempt from routine on-site licensing surveys.

Regulation

LAC 48:I, Chapters 56 and 57 (BHS Providers); R.S. 40:2151-2162

1. Request the initial BHS provider licensure application packet from LDH Health Standards Section
2. Obtain, if applicable, the State Fire Marshal (OSFM) plan review approval letter and on-site inspection approval for occupancy
3. Obtain the Office of Public Health inspection report recommending licensure
4. Assemble the packet: application, non-refundable fee, criminal background checks (within 90 days) on owners and managing employees, proof of financial viability, org chart, floor sketch, and other listed items
5. Submit the packet to LDH; facility need approval applies where required
6. Pass the announced initial on-site licensing survey; LDH issues a full license or a provisional initial license of up to six months

Program

Louisiana Medicaid (Louisiana Department of Health) — Healthy Louisiana

Enrollment portal

Louisiana Medicaid Provider Enrollment Portal (via www.lamedicaid.com)

Fiscal agent

Gainwell Technologies (Louisiana Medicaid fiscal intermediary; runs provider enrollment and screening)

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

Louisiana applies fingerprint-based criminal background checks by risk level at enrollment and at every 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

Louisiana applies site visits by risk level at enrollment and at every revalidation. 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

Louisiana revalidates all providers, including ordering/referring providers, at least every five years, and DMEPOS providers every three years. Notices go out by email and letter; there are no exemptions or extensions, and missing the due date means denied claims and deactivation, requiring a full new application. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Louisiana Medicaid enrollment guide →

CON program

Yes

Program

Facility Need Review (FNR)

Agency

Louisiana Department of Health, Health Standards Section (FNR program)

Services covered

• nursing facilities and nursing facility beds (licensed and Medicaid-certified)
• HCBS providers: personal care attendant, supervised independent living, monitored in-home caregiving and respite
• hospice providers and inpatient hospice facilities
• pediatric day health care facilities
• behavioral health providers offering psychosocial rehabilitation (PSR) and/or community psychiatric support and treatment (CPST)
• residential substance abuse treatment
• opioid treatment program clinics
• ICF/IID

Moratoria

A statutory moratorium (R.S. 40:2116.1(B)) bars new FNR approvals for nursing facilities or additional nursing facility beds until it expires; the rules separately allow relocation, conversion and abeyance of existing beds.

Louisiana certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

Direct-care wage floor

OCDD waivers (New Opportunities, Children's Choice, Supports, Residential Options): since 2021-10-01 direct support workers must be paid at least $9.00/hour, alongside a $2.50/hour rate increase.

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)

2,117 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,264,327 (as of Jun 1, 2026)

All Louisiana Behavioral health Medicaid rates, ranked →

• Adult Day Health Care (ADHC) Waiver (1915(c))
• Children's Choice (CC) Waiver (1915(c))
• Community Choices (CC) Waiver (1915(c))
• Coordinated System of Care (CSoC) Severely Emotionally Disturbed (SED) Children's Waiver (1915(c))
• New Opportunities Waiver (NOW) (1915(c))
• Residential Options Waiver (ROW) (1915(c))
• Supports Waiver (1915(c))

Louisiana waivers and waiting lists →