How to start a behavioral health clinic in Oregon
Oregon requires a OHA Health Systems Division certificate of approval for behavioral health treatment services (outpatient mental health and/or SUD services under the listed service delivery rules, e.g., OAR 309-019) from Oregon Health Authority — Health Systems Division (behavioral health licensing and certification) to operate a behavioral health clinic. Processing time: OHA audits application materials within 60 days of receipt; applicants have 14 calendar days to amend an incomplete application.
- License required
- YesOHA Health Systems Division certificate of approval for behavioral health treatment services (outpatient mental health and/or SUD services under the listed service delivery rules, e.g., OAR 309-019)
- Application fee
- —
- Processing time
- —
- Mental health counseling
- $39.75per hour
- Organizations in the state
- 1,323NPPES, Sep 13, 2026
On this page
Oregon behavioral health clinic license
Oregon requires a OHA Health Systems Division certificate of approval for behavioral health treatment services (outpatient mental health and/or SUD services under the listed service delivery rules, e.g., OAR 309-019) from Oregon Health Authority — Health Systems Division (behavioral health licensing and certification) to operate a behavioral health clinic. Processing time: OHA audits application materials within 60 days of receipt; applicants have 14 calendar days to amend an incomplete application.
- License required
- Yes
- License
- OHA Health Systems Division certificate of approval for behavioral health treatment services (outpatient mental health and/or SUD services under the listed service delivery rules, e.g., OAR 309-019)
- Issuing agency
- Oregon Health Authority — Health Systems Division (behavioral health licensing and certification)
- Renewal
- Every 3 years · Initial certificates last up to one calendar year; renewals last up to three calendar years.
- Processing time
- OHA audits application materials within 60 days of receipt; applicants have 14 calendar days to amend an incomplete application.
- Accreditation
- Not stated as required. Oregon is one of the original federal CCBHC demonstration states (OHA has a CCBHC demonstration application).
- Survey and inspection
- Certification review before issuance; OHA may inspect service locations and records at reasonable hours.
- Regulation
- OAR 309-008 (Certification of Behavioral Health Treatment Services), incl. 309-008-0250, -0400, -0500, -0900; ORS 743A.168
Steps to get licensed in Oregon
In order, as the licensing agency describes the process.
- Request the certification application and instructions from the OHA Health Systems Division
- Prepare a detailed implementation plan for the proposed services under the applicable service delivery rules and a written attestation that all rules will be met
- Submit one application covering all service delivery locations, with documentation for each location
- OHA audits the materials within 60 days and schedules a certification review if complete and compliant
- Pass the certification review (and any plan of correction); receive an initial certificate for up to one year, then renew for up to three years
What you need to submit
4 documents listed by the licensing agency.
Enrolling as a Oregon Medicaid provider
- Program
- Oregon Health Plan (OHP), Oregon Health Authority (OHA)
- Enrollment portal
- Oregon MMIS Provider Portal (or-medicaid.gov)
- 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. OHA's enrollment page does 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. The OHA enrollment and revalidation pages do not describe a separate state fingerprint 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 OHA enrollment and revalidation pages do not describe a separate state site visit process.
- Revalidation
- OHA rescreens every actively enrolled provider at least once every 5 years. It mails a notice to the provider's mail-to address. The provider returns the listed forms (for organizations OHA 3972, 3974 and 3975; for payable individuals OHA 3972 and 3975; for other individuals OHP 3113 and OHA 3975) by the due date, ideally online through the MMIS Provider Portal. If the forms are not returned, participation can end under OAR 410-120-1260. A revalidation received within 30 days after inactivation is treated as a revalidation; after that it is treated as a re-enrollment.
Does Oregon require a certificate of need?
- CON program
- Yes
- Program
- Certificate of Need
- Services covered
- new hospitals
- new skilled nursing or intermediate care services or facilities (long-term care), including rebuilds and bed relocations through expedited review
Oregon wage floor
- State minimum wage
- $15.55 an hour
- Effective
- 2026-07-01
- Scheduled increases
- Adjusted each July 1 by CPI (US DOL); the July 2027 rates were not yet published in the sources reviewed.
- Direct-care wage floor
- Homecare and personal support workers paid through ODHS earn a base rate set by collective bargaining: $21.25/hour at step 1 for 2026, plus add-ons (CPR/first aid, enhanced and exceptional pay).
- 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.
Oregon market size
Counts from federal public files: NPPES (active organization NPIs), CMS Care Compare and CMS Medicaid enrollment.
- Community/behavioral health agencies and mental health clinics — active organization NPIs (NPPES)
- 1,323 (as of Sep 13, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 1,264,858 (as of Jun 1, 2026)
What Oregon Medicaid pays
Behavioral health: published Oregon fee-for-service rates, each linked to its source.
| Service | Code | Oregon rate | Per hour | Rank |
|---|---|---|---|---|
| Mental health counselingLicensed mental health clinician | H0046 | $39.75per hour | $39.75 | — |
| Outpatient psychotherapy and diagnostic evaluationLicensed mental health clinician | 90867 | $125.09per unit | — | — |
| Mental health assessment (non-physician)Physician or licensed psychologist | H0031 | $127.34per unit | — | — |
| Skills training and developmentPhysician or licensed psychologist | H2014 | $26.63per 15 min | $106.52 | 6 of 33 |
| Mental health service plan developmentLicensed mental health clinician | H0032 | $157.13per unit | — | — |
Oregon HCBS waivers
Medicaid home and community-based services programs that may pay for this service.
- OR Adults' HCBS Waiver (1915(c))
- OR Aged and Physically Disabled Waiver (1915(c))
- OR Behavioral (ICF/IDD) Model Waiver (1915(c))
- OR Children's Extraordinary Needs Waiver (1915(c))
- OR Children's HCBS Waiver (1915(c))
- OR Medically Fragile (Hospital) Model Waiver (1915(c))
- OR Medically Involved Children's Waiver (MICW) (1915(c))
- Oregon Project Independence - Medicaid (1115)
Frequently asked questions
Do you need a license to start a behavioral health clinic in Oregon?
Oregon requires a OHA Health Systems Division certificate of approval for behavioral health treatment services (outpatient mental health and/or SUD services under the listed service delivery rules, e.g., OAR 309-019) from Oregon Health Authority — Health Systems Division (behavioral health licensing and certification) to operate a behavioral health clinic. Processing time: OHA audits application materials within 60 days of receipt; applicants have 14 calendar days to amend an incomplete application.
How long does it take to get licensed in Oregon?
OHA audits application materials within 60 days of receipt; applicants have 14 calendar days to amend an incomplete application.
Does Oregon require a certificate of need for a behavioral health clinic?
Oregon has a certificate of need program covering: new hospitals, new skilled nursing or intermediate care services or facilities (long-term care), including rebuilds and bed relocations through expedited review. Check whether your service is on that list.
How do you become a Medicaid provider in Oregon?
Enroll through Oregon MMIS Provider Portal (or-medicaid.gov) (https://www.or-medicaid.gov/).
What does Oregon Medicaid pay a behavioral health clinic?
Oregon Medicaid pays $39.75 per hour for mental health counseling, effective Jul 1, 2024.