How to start a behavioral health clinic in District of Columbia
District of Columbia requires a DBH certification as an MHRS provider (Core Services Agency, sub-provider or specialty provider) under 22-A DCMR Ch. 34; SUD treatment and recovery providers certified under 22-A DCMR Ch. 63 from District of Columbia Department of Behavioral Health (DBH) to operate a behavioral health clinic.
- License required
- YesDBH certification as an MHRS provider (Core Services Agency, sub-provider or specialty provider) under 22-A DCMR Ch. 34; SUD treatment and recovery providers certified under 22-A DCMR Ch. 63
- Application fee
- —
- Processing time
- —
- Mental health counseling
- $35.74
- Organizations in the state
- 563NPPES, Sep 13, 2026
On this page
District of Columbia behavioral health clinic license
District of Columbia requires a DBH certification as an MHRS provider (Core Services Agency, sub-provider or specialty provider) under 22-A DCMR Ch. 34; SUD treatment and recovery providers certified under 22-A DCMR Ch. 63 from District of Columbia Department of Behavioral Health (DBH) to operate a behavioral health clinic.
- License required
- Yes
- License
- DBH certification as an MHRS provider (Core Services Agency, sub-provider or specialty provider) under 22-A DCMR Ch. 34; SUD treatment and recovery providers certified under 22-A DCMR Ch. 63
- Insurance and bonds
- Providers must carry at least the insurance required by their Human Care Agreement and show proof to DBH on request.
- Accreditation
- Required: since 2023-10-01 all MHRS providers must hold behavioral health accreditation from CARF, COA or The Joint Commission; provisional certification can follow provisional accreditation.
- Survey and inspection
- On-site survey at initial application and renewal, and at any other time during certification.
- Regulation
- 22-A DCMR Chapter 34 (MHRS Provider Certification Standards); 22-A DCMR Chapter 63 (SUD Treatment and Recovery Provider Certification)
Steps to get licensed in District of Columbia
In order, as the licensing agency describes the process.
- Obtain the DBH certification application (DBH accepts applications only for services and time windows it announces)
- Submit a complete certification application to DBH; incomplete applications are returned
- DBH reviews the application and conducts an on-site survey, with access to records, staff and consumers
- Correct any deficiencies through a Corrective Action Plan within 10 business days if DBH issues a Statement of Deficiency
- Receive certification for a period that runs with the provider's accreditation period; apply for renewal at least 90 days before expiration
What you need to submit
3 documents listed by the licensing agency.
Staffing and training requirements
- Staffing
- Core Services Agency: Medical Director who is a board-eligible psychiatrist
- Full-time Clinical Director who is an independently licensed qualified practitioner (may also be Medical Director if a board-eligible psychiatrist)
- Sub-providers and specialty providers: Clinical Director who is an independently licensed qualified practitioner
Enrolling as a District of Columbia Medicaid provider
- Program
- DC Medicaid (Department of Health Care Finance)
- Enrollment portal
- DC Medicaid Provider Data Management System (PDMS)
- Fiscal agent
- Gainwell Technologies (fiscal agent and claims vendor since March 2, 2026, replacing Conduent)
- Application fee
- DHCF has collected the institutional application fee at enrollment and re-enrollment since May 1, 2015, under the District's Medicaid provider screening, enrollment and termination rule. 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
- 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
- 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
- Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
Does District of Columbia require a certificate of need?
- CON program
- Yes
- Program
- Certificate of Need
- Services covered
- hospitals (general, psychiatric, rehabilitation, specialty)
- skilled nursing facilities
- intermediate care facilities
- ambulatory care centers / clinics
- ambulatory surgical facilities
- kidney disease treatment / freestanding hemodialysis
- diagnostic health care facilities
- home health agencies
- hospice
- new health services by facilities with operating budgets of $500,000+
- capital expenditures of $6M+ (hospitals) or $3.5M+ (other facilities)
- major medical equipment ($3.5M hospitals / $2M other facilities / $350,000 single physician-owned unit)
- bed relocations and redistribution
- Moratoria
- SHPDA may impose a moratorium of up to 120 days on CONs for a specific service while it develops review standards; the same service cannot be placed under moratorium more than once in 12 months (D.C. Code §44-418). No standing moratorium identified.
District of Columbia wage floor
- State minimum wage
- $18.40 an hour
- Effective
- 2026-07-01
- Scheduled increases
- Adjusted each July 1 by formula (US DOL); the July 2027 rate was not yet published in the sources reviewed.
- Direct-care wage floor
- For FY2026, DC must pay direct care service providers a rate that supports direct care professional pay at the highest of: 117.6% of the DC living wage in effect on 2025-07-01, the current DC minimum wage, or the current DC living wage. DHCF's supplemental payment program requires eligible HCBS providers to pay their direct care workforce, on average, at or above the target wage.
- Rate pass-through
- Supplemental payments must fund wages, salaries and benefits of direct care professionals (DHCF Transmittal 25-03).
- 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.
District of Columbia 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)
- 563 (as of Sep 13, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 237,170 (as of Jun 1, 2026)
What District of Columbia Medicaid pays
Behavioral health: published District of Columbia fee-for-service rates, each linked to its source.
| Service | Code | District of Columbia rate | Per hour | Rank |
|---|---|---|---|---|
| Mental health counselingLicensed mental health clinician | H0046 | $35.74 | — | 3 of 12 |
| Outpatient psychotherapy and diagnostic evaluationLicensed mental health clinician | 90838 | $100.28per hour | $100.28 | — |
| Mental health assessment (non-physician)Physician or licensed psychologist | H0031 | $295.78 | — | 4 of 27 |
| Skills training and developmentPhysician or licensed psychologist | H2014 | $27.60per 15 min | $110.40 | 5 of 33 |
| Mental health service plan developmentLicensed mental health clinician | H0032 | $21.97 | — | 11 of 18 |
All District of Columbia Behavioral health Medicaid rates, ranked →
District of Columbia HCBS waivers
Medicaid home and community-based services programs that may pay for this service.
- Adult Day Health Program (ADHP) (1915(i))
- Elderly and Persons with Physical Disabilities Waiver (1915(c))
- People with Intellectual and Developmental Disabilities (IDD) Waiver (1915(c))
- Individual and Family Support (IFS) Waiver (1915(c))
Frequently asked questions
Do you need a license to start a behavioral health clinic in District of Columbia?
District of Columbia requires a DBH certification as an MHRS provider (Core Services Agency, sub-provider or specialty provider) under 22-A DCMR Ch. 34; SUD treatment and recovery providers certified under 22-A DCMR Ch. 63 from District of Columbia Department of Behavioral Health (DBH) to operate a behavioral health clinic.
Does District of Columbia require a certificate of need for a behavioral health clinic?
District of Columbia has a certificate of need program covering: hospitals (general, psychiatric, rehabilitation, specialty), skilled nursing facilities, intermediate care facilities, ambulatory care centers / clinics, ambulatory surgical facilities, kidney disease treatment / freestanding hemodialysis, diagnostic health care facilities, home health agencies, hospice, new health services by facilities with operating budgets of $500,000+, capital expenditures of $6M+ (hospitals) or $3.5M+ (other facilities), major medical equipment ($3.5M hospitals / $2M other facilities / $350,000 single physician-owned unit), bed relocations and redistribution. Check whether your service is on that list.
How do you become a Medicaid provider in District of Columbia?
Enroll through DC Medicaid Provider Data Management System (PDMS) (https://www.dcpdms.com/), run by Gainwell Technologies (fiscal agent and claims vendor since March 2, 2026, replacing Conduent).
What does District of Columbia Medicaid pay a behavioral health clinic?
District of Columbia Medicaid pays $35.74 for mental health counseling, effective Jun 1, 2025, ranking 3 of 12 states.