How to start a behavioral health clinic in Alabama
Alabama requires a ADMH certification as a community mental health and/or substance use services provider from Alabama Department of Mental Health — Division of Mental Health & Substance Use Services, Office of Certification to operate a behavioral health clinic. Processing time: ADMH says only that certification can take a considerable amount of time; no set timeline is published.
- License required
- YesADMH certification as a community mental health and/or substance use services provider
- Application fee
- —
- Processing time
- —
- Outpatient psychotherapy and diagnostic evaluation
- $80.12
- Organizations in the state
- 1,055NPPES, Sep 13, 2026
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Alabama behavioral health clinic license
Alabama requires a ADMH certification as a community mental health and/or substance use services provider from Alabama Department of Mental Health — Division of Mental Health & Substance Use Services, Office of Certification to operate a behavioral health clinic. Processing time: ADMH says only that certification can take a considerable amount of time; no set timeline is published.
- License required
- Yes
- License
- ADMH certification as a community mental health and/or substance use services provider
- Issuing agency
- Alabama Department of Mental Health — Division of Mental Health & Substance Use Services, Office of Certification
- Processing time
- ADMH says only that certification can take a considerable amount of time; no set timeline is published.
- Accreditation
- Alabama was one of ten states added to the federal CCBHC Medicaid demonstration in 2024; ADMH publishes CCBHC policy bulletins (e.g., for outpatient MH and SUD services).
- Survey and inspection
- The Office of Certification performs onsite reviews of community MH and SUD providers against the Program Operations administrative code and offers technical assistance.
- Regulation
- Ala. Admin. Code Chapters 580-2-20 (MH & SU program operations), 580-2-9 (MH services), 580-9-44 (SU services)
Steps to get licensed in Alabama
In order, as the licensing agency describes the process.
- Read the Alabama Administrative Code Chapter 580 standards for the services you plan to offer
- Complete ADMH's Prospective Provider Orientation (Phase 1 and Phase 2) through the ADMH Relias Academy and get the completion certificate
- Submit the certification application through ADMH's ACAP (Alabama Certification Automation Program) system
- Show compliance with the administrative code standards, including an onsite review by the Office of Certification
- Receive certification before delivering services
What you need to submit
2 documents listed by the licensing agency.
Enrolling as a Alabama Medicaid provider
- Program
- Alabama Medicaid
- Fiscal agent
- Gainwell Technologies (runs the Provider Enrollment Unit for the Alabama Medicaid Agency)
- Application fee
- Alabama collects the fee from new and re-enrolling institutional provider types on its fee list (e.g., ASCs, community mental health centers, DMEPOS suppliers, ESRD clinics, FQHCs), paid by certified or cashier's check to the Alabama Medicaid Agency; the agency's participation requirements document carries the current amount. Hardship exceptions can be requested through the fiscal agent. 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
- Alabama says skilled nursing facilities were moved to the high/moderate risk tier at CMS's direction, and high-risk enrollment triggers a fingerprint-based criminal background check. 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
- Alabama states SNFs get a site visit at initial enrollment and at each 5-year 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
- Alabama notifies providers when they are due and posts monthly lists of providers due for revalidation; a file closed for missing revalidation requires a brand-new application. Revalidations can be uploaded through the secure web portal. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
Does Alabama require a certificate of need?
- CON program
- Yes
- Program
- Certificate of Need
- Services covered
- hospitals (general, specialized, psychiatric, long-term care)
- skilled nursing facilities
- intermediate care facilities
- rehabilitation centers
- ambulatory surgery facilities
- kidney disease treatment / freestanding dialysis
- community mental health centers
- alcohol and drug abuse facilities
- facilities for the developmentally disabled
- hospice
- home health agencies
- health maintenance organizations
Alabama wage floor
- 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.
Alabama 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)
- 1,055 (as of Sep 13, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 930,919 (as of Jun 1, 2026)
What Alabama Medicaid pays
Behavioral health: published Alabama fee-for-service rates, each linked to its source.
| Service | Code | Alabama rate | Per hour | Rank |
|---|---|---|---|---|
| Outpatient psychotherapy and diagnostic evaluationLicensed mental health clinician | 90791 | $80.12 | — | 20 of 28 |
| Mental health assessment (non-physician)Physician or licensed psychologist | H0004 | $52.00per 15 min | $208.00 | — |
| Skills training and developmentPhysician or licensed psychologist | H0036 | $4.20per 15 min | $16.80 | 30 of 33 |
| Therapeutic behavioral servicesPhysician or licensed psychologist | H2019 | $4.20per 15 min | $16.80 | 28 of 28 |
| Mental health service plan developmentLicensed mental health clinician | H0032 | $22.00per 15 min | $88.00 | — |
Alabama HCBS waivers
Medicaid home and community-based services programs that may pay for this service.
- Community Transition (ACT) Waiver (1915(c))
- Community Waiver Program (1915(c))
- Home and Community-Based Waiver for the Elderly and Disabled (1915(c))
- Home and Community-Based Waiver for Persons with Intellectual Disabilities (1915(c))
- HCBS Living at Home Waiver for Persons with Intellectual Disabilities (LAH) Waiver (1915(c))
- SAIL Waiver (1915(c))
- Technology Assisted (TA) Waiver (1915(c))
Frequently asked questions
Do you need a license to start a behavioral health clinic in Alabama?
Alabama requires a ADMH certification as a community mental health and/or substance use services provider from Alabama Department of Mental Health — Division of Mental Health & Substance Use Services, Office of Certification to operate a behavioral health clinic. Processing time: ADMH says only that certification can take a considerable amount of time; no set timeline is published.
How long does it take to get licensed in Alabama?
ADMH says only that certification can take a considerable amount of time; no set timeline is published.
Does Alabama require a certificate of need for a behavioral health clinic?
Alabama has a certificate of need program covering: hospitals (general, specialized, psychiatric, long-term care), skilled nursing facilities, intermediate care facilities, rehabilitation centers, ambulatory surgery facilities, kidney disease treatment / freestanding dialysis, community mental health centers, alcohol and drug abuse facilities, facilities for the developmentally disabled, hospice, home health agencies, health maintenance organizations. Check whether your service is on that list.
How do you become a Medicaid provider in Alabama?
Enroll through Alabama Medicaid Electronic Provider Enrollment Application Portal (AMMIS) (https://medicaidhcp.alabamaservices.org/providerenrollment/Home/ProviderEnrollment/tabid/477/Default.aspx), run by Gainwell Technologies (runs the Provider Enrollment Unit for the Alabama Medicaid Agency).
What does Alabama Medicaid pay a behavioral health clinic?
Alabama Medicaid pays $80.12 for outpatient psychotherapy and diagnostic evaluation, effective Dec 1, 2025, ranking 20 of 28 states.