How to start a behavioral health clinic in Rhode Island
Rhode Island requires a Behavioral Healthcare Organization (BHO) license (212-RICR-10-10-1) covering clinical mental health and substance use disorder programs; CCBHC certification from Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) — Office of Licensing; CCBHC certification by BHDDH with the Executive Office of Health and Human Services (EOHHS) to operate a behavioral health clinic.
- License required
- YesBehavioral Healthcare Organization (BHO) license (212-RICR-10-10-1) covering clinical mental health and substance use disorder programs; CCBHC certification
- Application fee
- —
- Processing time
- —
- Mental health counseling
- $25.00
- Organizations in the state
- 317NPPES, Sep 13, 2026
On this page
Rhode Island behavioral health clinic license
Rhode Island requires a Behavioral Healthcare Organization (BHO) license (212-RICR-10-10-1) covering clinical mental health and substance use disorder programs; CCBHC certification from Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) — Office of Licensing; CCBHC certification by BHDDH with the Executive Office of Health and Human Services (EOHHS) to operate a behavioral health clinic.
- License required
- Yes
- License
- Behavioral Healthcare Organization (BHO) license (212-RICR-10-10-1) covering clinical mental health and substance use disorder programs; CCBHC certification
- Accreditation
- Required for partial hospitalization programs (recognized national accreditor); clubhouses need Clubhouse International accreditation. Rhode Island was one of ten states added to the federal CCBHC demonstration in 2024; a BHO license (or pending application) is a prerequisite for state CCBHC certification.
- Regulation
- 212-RICR-10-10-1 (Behavioral Healthcare Organizations); 212-RICR-10-00-1 (licensing procedures)
Steps to get licensed in Rhode Island
In order, as the licensing agency describes the process.
- Complete the BHDDH BHO Application for License (identify the CEO/director, board, programs and other licenses or accreditations)
- Attach the current State Fire Marshal inspection report, written job descriptions, a notarized list of all owners, officers and directors, the board list, and evidence of compliance with 212-RICR-10-00-1 Section 1.4
- Opioid treatment programs attach additional compliance evidence for OTP licensure
- Submit to BHDDH and complete licensing review and audit
- For CCBHC status, apply to the State for CCBHC certification once licensed as a BHO (or with BHO licensure pending)
What you need to submit
6 documents listed by the licensing agency.
Staffing and training requirements
- Staffing
- Program director for applicable programs must be a licensed mental health professional with at least two years of post-graduate clinical experience
- Interdisciplinary team of addiction treatment professionals for IOP (ASAM 2.1)
Enrolling as a Rhode Island Medicaid provider
- Program
- Rhode Island Medicaid (Executive Office of Health and Human Services, EOHHS)
- Fiscal agent
- Gainwell Technologies
- Application fee
- Some provider types must pay an application fee. EOHHS publishes the 2026 list of who pays, how much and how to pay ('Updated Provider Application Fees 2026'). Providers already screened by Medicare can rely on Medicare's screening and fee payment but must still complete RI's disclosure statements. 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 EOHHS enrollment pages we reviewed 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 EOHHS enrollment pages we reviewed do not describe a separate state site visit process.
- Revalidation
- EOHHS mails revalidation letters, and the provider has 35 days from the letter date to complete revalidation in the portal. Have an updated W-9 ready and expect the disclosure questions. Not revalidating leads to termination from RI Medicaid. Ordering, prescribing and referring (OPR) providers also revalidate. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.
Does Rhode Island require a certificate of need?
- CON program
- Yes
- Program
- Certificate of Need (Determination of Need for New Healthcare Equipment and New Institutional Health Services)
- Services covered
- hospitals
- nursing facilities
- home nursing-care providers
- home-care providers
- hospice providers and inpatient hospice facilities
- inpatient rehabilitation centers including drug/alcohol treatment
- freestanding emergency-care facilities
- multi-practice ambulatory surgery centers (single-practice physician/podiatry ASCs exempt unless set up by a medical practice group)
- capital expenditures above $5,250,000 (CPI-adjusted from 2012)
- new services adding $1,500,000+ (CPI-adjusted) in operating expense
- tertiary/specialty services listed in regulation (up to 12 categories)
Rhode Island wage floor
- State minimum wage
- $16.00 an hour
- Effective
- 2026-01-01
- Scheduled increases
- Rises to $17.00 on 2027-01-01 (2025-H 5029A / 2025-S 0125A).
- Rate pass-through
- Home care: agencies must pass 100% of the shift-differential and behavioral-health-training rate enhancements to the CNAs and homemakers who earned them. Nursing homes: 100% of the 3% base-rate staffing adjustment effective 2025-10-01 must go to direct-care staff compensation or added positions.
- 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.
Rhode Island 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)
- 317 (as of Sep 13, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 283,863 (as of Jun 1, 2026)
What Rhode Island Medicaid pays
Behavioral health: published Rhode Island fee-for-service rates, each linked to its source.
| Service | Code | Rhode Island rate | Per hour | Rank |
|---|---|---|---|---|
| Mental health counselingLicensed mental health clinician | 96152 | $25.00 | — | 7 of 12 |
| Outpatient psychotherapy and diagnostic evaluationLicensed mental health clinician | 90847 | $0.01 | — | — |
| Mental health assessment (non-physician)Physician or licensed psychologist | H0031 | $124.50 | — | 15 of 27 |
| Skills training and developmentPhysician or licensed psychologist | H2014 | $34.91per 15 min | $139.64 | 1 of 33 |
| Mental health service plan developmentLicensed mental health clinician | H0032 | $0.01 | — | — |
Rhode Island HCBS waivers
Medicaid home and community-based services programs that may pay for this service.
- Rhode Island Comprehensive Demonstration (1115)
Frequently asked questions
Do you need a license to start a behavioral health clinic in Rhode Island?
Rhode Island requires a Behavioral Healthcare Organization (BHO) license (212-RICR-10-10-1) covering clinical mental health and substance use disorder programs; CCBHC certification from Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) — Office of Licensing; CCBHC certification by BHDDH with the Executive Office of Health and Human Services (EOHHS) to operate a behavioral health clinic.
Does Rhode Island require a certificate of need for a behavioral health clinic?
Rhode Island has a certificate of need program covering: hospitals, nursing facilities, home nursing-care providers, home-care providers, hospice providers and inpatient hospice facilities, inpatient rehabilitation centers including drug/alcohol treatment, freestanding emergency-care facilities, multi-practice ambulatory surgery centers (single-practice physician/podiatry ASCs exempt unless set up by a medical practice group), capital expenditures above $5,250,000 (CPI-adjusted from 2012), new services adding $1,500,000+ (CPI-adjusted) in operating expense, tertiary/specialty services listed in regulation (up to 12 categories). Check whether your service is on that list.
How do you become a Medicaid provider in Rhode Island?
Enroll through RI Medicaid Healthcare Portal (riproviderportal.org) — Enrollment Application (https://www.riproviderportal.org/hcp/provider/Home/ProviderEnrollment/EnrollmentWelcome/tabid/442/Default.aspx), run by Gainwell Technologies.
What does Rhode Island Medicaid pay a behavioral health clinic?
Rhode Island Medicaid pays $25.00 for mental health counseling, effective Mar 25, 2013, ranking 7 of 12 states.