How to start a behavioral health clinic in Nebraska

Nebraska does not require a state license for a behavioral health clinic, according to Nebraska Department of Health and Human Services — Division of Public Health, Licensure Unit (Office of Developmental Disabilities & Behavioral Health Facilities). Nebraska — no DHHS facility license for outpatient-only behavioral health clinics; Mental Health Substance Use Treatment Center license covers residential programs.

License required

No

License

Mental Health Substance Use Treatment Center (MHSUTC) license — applies to facilities where clients live for more than 24 consecutive hours

Issuing agency

Nebraska Department of Health and Human Services — Division of Public Health, Licensure Unit (Office of Developmental Disabilities & Behavioral Health Facilities)

Fee

MHSUTC initial and renewal fee by beds: 1-16 beds $250; 17-50 beds $275; 51+ beds $300. Duplicate license $10. Denied applications are refunded minus a $25 administrative fee only if no inspection was done.

Renewal

Every year · MHSUTC licenses expire September 30 each year; renewal fee equals the initial fee for the bed count.

Processing time

Initial MHSUTC inspection takes place on site within 30 working days of a completed application.

Survey and inspection

Initial on-site inspection within 30 working days of a complete application; unannounced compliance inspections at any time.

Regulation

175 NAC 18; Nebraska Health Care Facility Licensure Act

1. Outpatient-only services delivered by licensed professionals in private practice under their own licenses are exempt from DHHS facility licensure
2. For a residential program (clients living on site over 24 hours), meet 175 NAC 18 and request an initial MHSUTC application from the Licensure Unit
3. Submit the completed application, documentation required by the regulations and the bed-based fee
4. Pass the initial on-site inspection before operating; later compliance inspections are unannounced

Program

Nebraska Medicaid (Heritage Health managed care), Division of Medicaid & Long-Term Care, Nebraska DHHS

Enrollment portal

Maximus Provider Data Management System (PDMS)

Fiscal agent

Maximus is the enrollment and screening contractor. DHHS's page sends fee-for-service claim questions to Nebraska DHHS Medicaid Claims Customer Service and names no separate claims fiscal agent.

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. Nebraska's screening and enrollment page does not list a separate state fee. The $55 fingerprint check is a separate cost (see fingerprinting).

Fingerprinting

Provider types that fall in the 'high risk' level of the Nebraska Medicaid Provider Risk Level list must complete a Fingerprint Criminal Background Check, both at enrollment and at revalidation. DHHS Provider Relations sends the packet. The check costs $55 through the Nebraska State Patrol; other fingerprint sites may add a fee. 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.

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. Nebraska's enrollment page does not describe a state-specific site visit process.

Revalidation

Every 5 years from the date of first enrollment. Maximus emails a notice as early as 180 days before the due date and sends reminders after that. The provider logs into PDMS, updates the record and submits it. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full Nebraska Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (Nebraska Health Care Certificate of Need Act)

Agency

Nebraska Department of Health and Human Services

Services covered

• new long-term care beds (nursing facility beds)
• long-term care bed increases above 10 beds or 10% (whichever is less) over two years
• new rehabilitation beds and rehabilitation bed increases above 10 beds or 10% over two years
• hospital conversion of beds to long-term care or rehabilitation beds above the same limits

Moratoria

All long-term care beds that need a CON are under a statutory moratorium unless an exception applies, such as a department finding that individuals with complex or intensive care needs are underserved (Neb. Rev. Stat. §71-5829.04). All rehabilitation beds that need a CON are under a moratorium unless statewide rehabilitation occupancy exceeded 90% for the last three consecutive quarters, or a regional occupancy exception applies (§71-5829.06).

Nebraska certificate of need details →

State minimum wage

$15.00 an hour

Effective

2026-01-01

Scheduled increases

LB 258 (approved 2026-02-09) changed the annual adjustment that starts 2027-01-01 and lets employers pay a $13.50 youth/training wage. The Nebraska DOL must publish the 2027 rate by 2026-10-15; it was not yet found.

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)

694 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

330,435 (as of Jun 1, 2026)

All Nebraska Behavioral health Medicaid rates, ranked →

• NE Comprehensive Developmental Disabilities Services Waiver (1915(c))
• NE Developmental Disabilities Day Services Waiver for Adults (1915(c))
• NE Family Support Waiver (1915(c))
• NE HCBS Waiver for Aged, Adults, and Children with Disabilities (1915(c))
• NE Traumatic Brain Injury Waiver (1915(c))

Nebraska waivers and waiting lists →