How to start a behavioral health clinic in New Hampshire

New Hampshire DHHS approval of Community Mental Health Programs (He-M 403); CCBHC demonstration state.

License

DHHS approval as a regional Community Mental Health Program (CMHP) under He-M 403; opioid treatment programs separately certified under He-A 304

Issuing agency

New Hampshire Department of Health and Human Services — Division for Behavioral Health (CMHP approval); Bureau of Drug and Alcohol Services (OTP certification)

Renewal

Every 5 years · CMHP approval runs for a 5-year term; reapproval follows He-M 403.11.

Processing time

DHHS opens the CMHP approval process at least 90 days before a designation period ends; site review is completed within 90 days of referral, and approval issues within 15 days after the site review.

Accreditation

Not stated as required. New Hampshire was one of ten states added to the federal CCBHC Medicaid demonstration in 2024.

Survey and inspection

DHHS site visit and review before approval.

Regulation

He-M 403 (Approval and Operation of Community Mental Health Programs); RSA 135-C:7, 135-C:10; He-A 304 (opioid treatment programs)

1. Wait for DHHS to publish a notice opening the CMHP approval process for a region (at least 90 days before the designation period ends)
2. Eligible applicants (cities, towns, counties, or boards of NH private nonprofits meeting governance rules) submit written assurances of compliance with DHHS mental health and client-rights rules
3. Document unmet need among eligible individuals (He-M 401) and submit a written proposal with a line-item budget and program descriptions
4. DHHS gathers regional comments and conducts a site visit within 90 days
5. DHHS approves compliant applicants within 15 days of the site review, for a 5-year term

Program

New Hampshire Medicaid (Fee for Service and Medicaid Care Management), NH DHHS

Enrollment portal

New Hampshire MMIS Health Enterprise Portal

Fiscal agent

Conduent (runs the NH MMIS portal and the Provider Relations call center)

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. NH DHHS provider pages do not list a separate state fee.

Fingerprinting

Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. NH DHHS provider pages do not list which provider types are high risk.

Site visit

NH DHHS says moderate- and high-risk providers must have a site visit and limited-risk providers do not. A Medicare site visit done within the past 5 years satisfies the requirement for NH Medicaid revalidation. Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections.

Revalidation

Every enrolled provider (billing, rendering and ordering/referring/prescribing) revalidates about every 5 years, online in the MMIS portal only. The state mails and emails notices 60 days and 30 days before the due date and on the due date itself. No extensions are given. A provider who misses revalidation can have claims suspended, then loses fee-for-service enrollment and, after that, its health plan participation. Revalidating with Medicare, with another state or with a health plan does not count. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full New Hampshire Medicaid enrollment guide →

CON program

No

Agency

New Hampshire Department of Health and Human Services (facility licensing)

Moratoria

RSA 151:2, VI bars new licenses and licensed-capacity increases for nursing homes, skilled nursing facilities, intermediate care facilities and rehabilitation facilities (including rehabilitation hospitals). Exceptions cover substance use / mental health rehabilitation facilities, continuing care facilities with an insurance-commissioner certificate of authority, and same-county transfers of beds that existed on July 1, 2016 without reducing county Medicaid beds. Pediatric ICFs existing before July 1, 2023 may house 2 extra residents through June 30, 2026.

New Hampshire 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.

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)

366 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

167,648 (as of Jun 1, 2026)

All New Hampshire Behavioral health Medicaid rates, ranked →

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New Hampshire waivers and waiting lists →