How to start a behavioral health clinic in New Jersey

New Jersey requires a Outpatient facility license under N.J.A.C. 8:43K listing the Outpatient Behavioral Health service (outpatient, intensive outpatient and/or partial care for mental health and/or SUD); replaced N.J.A.C. 10:161B outpatient SUD licensure from New Jersey Department of Health — Office of Certificate of Need and Health Care Facility Licensing to operate a behavioral health clinic. Fee: Under N.J.A.C. 8:43K-2.8(d), $250 for the Outpatient Behavioral Health service at each facility location (also $250 each for primary care, reproductive health and opioid treatment programs); $1,000 per alternate care location; $250 per mobile van; $375 for a waiver application. The base license fee in 8:43K-2.8(a)-(c) was not printed in the adoption notice reviewed.

License required

Yes

License

Outpatient facility license under N.J.A.C. 8:43K listing the Outpatient Behavioral Health service (outpatient, intensive outpatient and/or partial care for mental health and/or SUD); replaced N.J.A.C. 10:161B outpatient SUD licensure

Issuing agency

New Jersey Department of Health — Office of Certificate of Need and Health Care Facility Licensing

Fee

Under N.J.A.C. 8:43K-2.8(d), $250 for the Outpatient Behavioral Health service at each facility location (also $250 each for primary care, reproductive health and opioid treatment programs); $1,000 per alternate care location; $250 per mobile van; $375 for a waiver application. The base license fee in 8:43K-2.8(a)-(c) was not printed in the adoption notice reviewed.

Renewal

Every 2 years · DOH sends a renewal request with the fee 30 days before expiration; the licensure period is two years (extended from one year in the new rules).

Accreditation

Optional; accredited facilities may renew by deemed status (8:43K-2.6), and accreditation may substitute for routine licensure surveys. Separately, NJ DHS (DMHAS with DMAHS) certifies CCBHCs against state criteria under its CCBHC demonstration program.

Survey and inspection

DOH may conduct an on-site survey before initial or renewal licensure and issues a written report of deficiencies.

Regulation

N.J.A.C. 8:43K (effective 2026-04-06), incl. 8:43K-2.1 to 2.8; N.J.S.A. 26:2H-1 et seq.; former N.J.A.C. 10:161B (repealed)

1. Complete the DOH licensure application form (N.J.A.C. 8:43E-5 Appendix) and the schedules for each service sought, available at nj.gov/health/forms
2. Submit to the DOH Office of Certificate of Need and Health Care Facility Licensing with the fees
3. Follow DCA Uniform Construction Code facility construction project review
4. DOH may conduct an on-site survey; correct any cited deficiencies and notify DOH
5. Receive the license listing each approved service and location; renew every two years (deemed-status renewal available for accredited facilities)

Program

NJ FamilyCare / New Jersey Medicaid (Division of Medical Assistance and Health Services, NJ Department of Human Services)

Enrollment portal

NJMMIS.com Provider Enrollment Applications (downloadable packages by provider type)

Fiscal agent

Gainwell Technologies

Application fee

Some provider types must pay an application fee unless they paid one recently. Proof of a fee paid to Medicare or another state's Medicaid program in the past 5 years can be attached instead. Otherwise the payment goes to the NJ Division of Revenue lockbox with the application. 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.

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. The NJMMIS enrollment pages we reviewed do not describe a separate state fingerprinting process.

Site visit

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. The NJMMIS enrollment pages we reviewed do not describe a separate state site visit process.

Revalidation

New Jersey revalidates providers every five years under the ACA. To revalidate, file the full enrollment package for your provider type with the Revalidation Cover Page on top; requests without the cover page are not processed. Signatures can be electronic. Send it by secure email, fax or mail to the Gainwell Provider Revalidation Unit. If you don't return the package, claims may be pended or denied. Revalidation Unit: 1-833-909-1522. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full New Jersey Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (full review and Expedited Review, ERCN)

Agency

New Jersey Department of Health, Certificate of Need and Healthcare Facility Licensure; State Health Planning Board advises the Commissioner on full-review applications

Services covered

• long-term care (general, ventilator, pediatric)
• rehabilitation beds
• psychiatric beds
• new general hospitals and children's hospitals
• transfer of ownership of a general hospital
• maternal and child health, pediatric intensive care
• transplantation, burn centers, trauma units, mobile intensive care units
• home health
• new assisted living facilities
• hospital sub-acute unit capacity changes
• establishment, capacity, scope, location or cost changes and major moveable equipment for covered facilities (often expedited)

New Jersey certificate of need details →

State minimum wage

$15.92 an hour

Effective

2026-01-01

Scheduled increases

Rises to $16.48 on 2027-01-01 for most employers; $16.25 for seasonal and small employers; $15.00 for agricultural workers.

Direct-care wage floor

Long-term care facility direct care staff must be paid $3.00/hour above the standard state minimum wage ($18.92 in 2026); this rises to $19.48 on 2027-01-01.

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)

4,420 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,725,496 (as of Jun 1, 2026)

All New Jersey Behavioral health Medicaid rates, ranked →

• New Jersey FamilyCare Comprehensive Demonstration (1115)

New Jersey waivers and waiting lists →