How to start a behavioral health clinic in Vermont

Vermont — DMH agency designation (designated/specialized service agencies), VDH SUD treatment program certification (Preferred Providers), and CCBHC certification.

License

Department of Mental Health Agency Designation (18 V.S.A. 8907); Vermont Department of Health substance use treatment provider certification (Preferred Provider Network); CCBHC certification

Issuing agency

Vermont Agency of Human Services — Department of Mental Health (DMH) and Department of Health, Division of Substance Use Programs (DSU)

Accreditation

Vermont was one of ten states added to the federal CCBHC Medicaid demonstration in 2024 (enhanced FMAP July 2025 to June 2029); the first Vermont CCBHCs received preliminary certification effective 2025-07-01.

Regulation

18 V.S.A. 8907 and Administrative Rules on Agency Designation; Vermont Substance Abuse Treatment Certification Rule

1. For publicly funded SUD treatment, obtain Department of Health treatment provider certification and a DSU contract or grant to join the Preferred Provider Network
2. Deliver services under the current ASAM Criteria (e.g., outpatient ASAM 1, intensive outpatient ASAM 2.1)
3. For community mental health services, obtain DMH Agency Designation under 18 V.S.A. 8907 and the Administrative Rules on Agency Designation
4. Designated agencies may seek CCBHC certification from DMH and the Department of Health

Program

Vermont Medicaid / Green Mountain Care (Department of Vermont Health Access, DVHA)

Enrollment portal

Provider Management Module (PMM)

Fiscal agent

Gainwell Technologies (enrollment department and revalidation notices)

Application fee

Under 42 CFR 455.460, institutional and certain other providers pay the application fee on initial enrollment, new practice locations and revalidation. Proof of payment goes to DVHA with the application. The fee is waived if already paid to Medicare, another state's Medicaid program or another Vermont state agency. CMS decides hardship waivers, and DVHA passes on the result. 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

High-risk providers get a fingerprint-based criminal background check. DVHA follows the CMS risk categories, under which newly enrolling DMEPOS suppliers and newly enrolling home health agencies are high risk. DVHA may raise a provider's risk level at any time, for example after a payment suspension, exclusion or Medicare revocation.

Site visit

Moderate-risk providers get on-site visits, for example ambulance suppliers, community mental health centers, CORFs, hospices, independent clinical labs, IDTFs and physical therapists. High-risk providers get them too.

Revalidation

Providers get system notices 90 and 45 days before their contract end date, and screening is repeated at revalidation. Missing the deadline ends enrollment, and coming back requires a new application. Under its 2026 strategy, Vermont is revalidating high-risk providers off-cycle starting July 1, 2026 and selected moderate-risk providers starting January 1, 2027 (about 300 providers); Gainwell contacts those affected. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full Vermont Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Green Mountain Care Board (GMCB)

Services covered

• construction, purchase, renovation or capital expenditure by a health care facility above $10,000,000
• changes in licensed bed counts (addition, conversion or relocation)
• offering any home health service
• transfer of more than 50% ownership of a health care facility other than a hospital or nursing home
• single diagnostic or therapeutic equipment items above $5,000,000
• new services or technology with annual operating expense above $3,000,000
• conceptual development phase CON for projects above $50,000,000

Vermont certificate of need details →

State minimum wage

$14.42 an hour

Effective

2026-01-01

Scheduled increases

Adjusted each January 1 by CPI; the 2027 rate was not found in the 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.

Community/behavioral health agencies and mental health clinics — active organization NPIs (NPPES)

202 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

145,492 (as of Jun 1, 2026)

All Vermont Behavioral health Medicaid rates, ranked →

• Vermont Global Commitment to Health (1115)

Vermont waivers and waiting lists →