How to start an IOP in New York: OASAS certification, Part 822 and the steps

Who wrote this, honestly

We're Texas operators: we run a licensed Texas outpatient program, PHP through outpatient, and built our own EHR to run it. When we help an owner open in another state, the first task on that client's roadmap is "apply for your state's SUD treatment program license", and the work behind it is finding the state's rule and checking it against the agency's current text. This guide is that check for New York, and it's the same work our IOP / PHP Program Launch does for a client opening outside Texas. Where we couldn't confirm a detail from New York's regulations or OASAS publications, we left it out or told you who to ask.

Comparing the Northeast? Read our guides for New Jersey, Pennsylvania and Massachusetts, or how to start an IOP or PHP in Texas for a state that licenses the building rather than reviewing need.

New York at a glance

Question	New York's answer
Who approves an outpatient SUD program	The NYS Office of Addiction Services and Supports (OASAS), through its Bureau of Certification
Statute	Mental Hygiene Law Articles 19 and 32 (operating certificates for addiction services)
Approval rule	14 NYCRR Part 810: prior approval to establish, incorporate, build or add a service; full or administrative review
Service rule	14 NYCRR Part 822: general service standards for SUD outpatient programs; intensive outpatient is defined in 822.5
New provider	Full review, with the application listed on the Behavioral Health Services Advisory Council (BHSAC) Project Review Committee agenda
Counselor credential	OASAS's own CASAC-Trainee, CASAC, CASAC 2 and CASAC Advanced Counselor, plus State Education Department licensed professionals
Medicaid payment	APGs for OASAS Article 32 outpatient services, with upstate and downstate peer groups, in fee-for-service and managed care
Brokering	A 2018 state law bans referral fees for placement in a substance use program; OASAS runs a reporting hotline

An operating certificate, granted on prior approval

New York doesn't sell a license over the counter. Under 14 NYCRR Part 810, the commissioner's prior approval is required before a provider establishes, incorporates or constructs a facility or offers a service, and the Part applies to every existing or prospective provider that needs an operating certificate under Mental Hygiene Law Articles 19 and 32. Part 822 then says it plainly: a provider of outpatient services needs an operating certificate issued under Part 810 (section 822.3).

Part 810 covers the application types (full and administrative review, 810.5 and 810.6), the standards for approval (810.7), how each review runs (810.8 and 810.9), the actions that need prior approval later on (810.10), and certification itself (810.12). Read 810.7 before anything else: it's the test your application has to pass.

Part 810 is changing. OASAS published proposed amendments in the State Register on June 17, 2026, with comments open until August 16, 2026. Per the OASAS summary presented to the council in December 2025, the changes add a new sponsor application to the applications that get a full review and align the definition of "governing authority" with Part 800. Check whether the amendments have been adopted when you file.

Full review and the advisory council

This is what sets New York apart from most states we cover, and it decides your timeline.

• New providers get a full review. OASAS sorts certification applications into administrative and full reviews, and its project agendas list "New OASAS Provider" under full reviews.
• A staff memo. A Bureau of Certification analyst writes up each application for the Director of the Certification Bureau. The memos we read describe the applicant, the Part 822 services requested, and the need for those services in the area.
• A council vote. Full-review applications go on the agenda of the Behavioral Health Services Advisory Council's Project Review Committee, which votes on a recommendation. The minutes record recommendations of approval, sometimes with abstentions. OASAS posts each meeting's project list, so you can read past applications for new Part 822 providers and see how they were framed.
• Ownership and experience matter. Change-of-ownership memos we read discuss the owners' experience and whether population, staffing, budget or policies would change. Expect the same questions about a new owner, and have each owner's background ready.

What it means for you. Your application is a case, not a form: who will be served, what services are missing where you'll open, who owns and runs the program, and why they can. Write the need section with local data, and line up referral relationships with hospitals, courts and primary care before you file. OASAS's own certification process presentation to the council describes the roles and stages; ask the Bureau of Certification for current timelines rather than planning on one. Our IOP business plan guide covers the market and budget sections a reviewer reads first.

The rules to read

Rule or document	What it covers
Mental Hygiene Law Articles 19 and 32	OASAS's authority and the operating certificate requirement
14 NYCRR Part 810	Establishment, incorporation and certification: prior approval, full and administrative review, standards, actions that need approval later
14 NYCRR Part 800	General definitions used across OASAS rules, including "qualified health professional" and "governing authority"
14 NYCRR Part 822	General service standards for SUD outpatient programs; 822.5 defines the services, including intensive outpatient
Part 822 Clinical Standards	OASAS's companion document on quality in outpatient SUD treatment
OASAS APG Manual	Medicaid billing for OASAS outpatient services: rate codes, procedure codes, peer groups

Our launch package builds the policy manual as a crosswalk: every requirement in Part 822, Part 800 and your accreditor's standards matched to a policy, form or record. In New York that crosswalk also feeds the application, because the reviewer wants to see you understand the rules before you're approved.

What Part 822 asks of an IOP

In New York, intensive outpatient is a service an OASAS-certified Part 822 outpatient program provides, not a separate facility type. Section 822.5 defines intensive outpatient services as a time-limited outpatient service delivered by a clinical team for patients who need a structured, multi-component program to reach and maintain recovery.

Part 822 requirement	What it means for your build
Individual and group counseling	Both on the schedule every week, with a named clinician for each client
Family counseling, when appropriate	A family session option and the consents for it; see our family program guide
Relapse prevention and coping skills training	Curriculum topics you can show a surveyor; our IOP group curriculum has a starting list
Evidence-based approaches, as appropriate	The rule names Dialectical Behavior Therapy, Motivational Enhancement Therapy and Cognitive Behavioral Therapy; train staff in the ones you'll claim

The Justia copy we read is current through September 2024, and OASAS proposed Part 822 amendments in 2022. Pull the official text before you write policies. Hours per week are set by your service design, ASAM and payer rules rather than a number we found in 822.5; our guide to IOP vs. PHP vs. outpatient explains the usual ASAM Level 2.1 ranges, and the IOP schedule template shows how a week fits together.

CASACs and staffing

New York is unusual: the same agency that certifies your program credentials your addiction counselors. OASAS's CASAC page sets these levels:

Credential	What OASAS requires
CASAC-Trainee	350 education hours, or 85 education hours plus 15 hours of addiction-specific ethics and 4,000 hours of approved work experience; high school diploma or equivalency
CASAC	6,000 hours (about three years) of supervised work experience in an approved setting, including 300 hours of supervised practical training; 350 clock hours of education; a criminal background check; and the OASAS-approved exam
CASAC 2	The CASAC requirements plus at least an associate's degree in an approved human services field and two ethics evaluation forms
CASAC Advanced Counselor	A CASAC, a bachelor's degree and 30 hours of clinical supervision training

Renewal takes 60 clock hours, including six hours of ethics. OASAS posts the CASAC application instructions and forms. Part 800 defines "qualified health professional", which includes CASACs and State Education Department licensees such as LMHCs, LCSWs and psychologists; OASAS rules use that term when they set staffing ratios and supervision, so read it before you write job descriptions. Part 800 also sets medical director qualifications; ask OASAS what your program's medical director must hold. A CASAC-Trainee can't carry an independent caseload without the supervision the rules require, so plan supervision coverage before you hire trainees.

Check every hire and owner against the federal OIG exclusion list and keep the proof in the file; our staff credential file checklist lists what goes in it. If you'll offer medication for addiction treatment, adding MAT to an IOP covers the prescriber side.

Medicaid: APGs, mainstream plans and HARPs

• APG payment. NYS Medicaid pays OASAS-certified Article 32 outpatient services with the Ambulatory Patient Group algorithm: a base rate multiplied by a procedure weight, with modifiers. The OASAS APG Manual splits programs into downstate and upstate peer groups and lists the rate codes, procedure codes and service codes for both fee-for-service and managed care billing. OASAS added a video on APG claim components in August 2025.
• Comprehensive Outpatient Programs. OASAS created COP rate codes for qualifying Part 822 programs, paid by APG; one plan's 2024 provider notice said OASAS expected COP programs to bill the new codes by November 2024. Ask OASAS whether a new program can qualify and when.
• Managed care. Your Medicaid clients may be in fee-for-service, a mainstream Medicaid managed care plan, or a Health and Recovery Plan (HARP), the plans for adults with serious behavioral health needs. Plans' notices for COP and opioid treatment billing list both mainstream plans and HARPs as affected, and OASAS publishes a coding crosswalk for HARP and mainstream services. Contract with the plans your clients carry, and confirm each plan's authorization rules before you admit.
• Medicare pays for IOP and PHP only through hospitals, community mental health centers and a few other provider types, so most freestanding programs plan without it (CMS 2024 outpatient rule).

Our credentialing service handles Medicaid enrollment, plan credentialing and facility contracts in any state; Medicaid enrollment is $500 per clinician. Before every admission, verify benefits and authorization; the VOB checklist covers what to ask a plan.

New York's patient brokering law

In 2018 New York passed a law, backed by OASAS, that bans cash or referral fees in exchange for placing someone in a particular substance use program (A7689-A; the sponsor's announcement). OASAS's Stop Treatment Fraud page describes brokers who collect payment from out-of-state providers for sending New Yorkers to them, and takes reports at 1-800-553-5790 or [email protected]. Pay marketers a salary, never per admission, and read our guides to patient brokering laws and marketing a treatment center before you hire anyone to bring in clients.

The steps, in order

1. Define the program: the Part 822 services you'll offer, adults or adolescents, intensive outpatient hours, and the region you'll serve.
2. Build the need case: who in that county lacks access to outpatient SUD care, and who will refer to you. Read recent BHSAC project lists for comparable applications.
3. Form the business with the NYS Department of State, get the EIN and the organization NPI, and line up a health-care attorney and CPA. Settle the governing authority before you file; the reviewer will ask who controls the program.
4. Find a site, and lease with a way out if prior approval, zoning or the certificate of occupancy falls through. Under Part 810, constructing a facility is itself something that needs prior approval.
5. File the Part 810 application with the OASAS Bureau of Certification, and answer the analyst's questions quickly.
6. Prepare for the Project Review Committee and the commissioner's decision.
7. Write the policy manual from Parts 800 and 822, plus 42 CFR Part 2 and HIPAA, and hire the medical director, clinical supervisor and CASACs.
8. Set up the EHR before you open: Cima's IOP and PHP plan keeps levels of care, group notes, attendance and authorizations in one place, which is what a record review checks.
9. Receive the operating certificate, then enroll with NYS Medicaid and contract with the mainstream plans and HARPs.
10. Keep it current: check 810.10 before you add a service or change the program, renew CASACs on time, and keep drills and chart reviews on a schedule with the compliance calendar.

Questions

Do you need a license to open an outpatient rehab in New York?

Yes. An outpatient substance use program needs an OASAS operating certificate under Mental Hygiene Law Articles 19 and 32. Under 14 NYCRR Part 810, the commissioner must approve the program before you establish it, build the facility or offer the service.

Is intensive outpatient a separate license in New York?

No. Intensive outpatient is a service of an OASAS-certified outpatient program under Part 822. Section 822.5 defines it as a time-limited service by a clinical team, with individual and group counseling, family counseling when appropriate, relapse prevention and coping skills training.

How long does OASAS certification take?

We didn't find a published timeline we could rely on. A new provider goes through a full review: a Bureau of Certification memo, then a recommendation from the Behavioral Health Services Advisory Council's Project Review Committee. Ask the Bureau of Certification for current timing, and file a complete application.

What does OASAS certification cost?

We didn't find an application fee in the OASAS material we read. The real costs are the months of rent and staff before approval, accreditation if your payers want it, and build-out. Our guide to what it costs to start an IOP covers the budget.

Who can counsel in a New York IOP?

OASAS credentials CASACs at several levels, and the State Education Department licenses mental health counselors, social workers and psychologists. OASAS rules use Part 800's "qualified health professional" definition for staffing and supervision, so check which roles each credential can fill.

Can a Texas company help with a New York program?

Yes, if it's honest about how. We run a Texas program, so in New York we work from Parts 800, 810 and 822 and OASAS's guidance, check each against the current text, and tell you where OASAS, Medicaid, the plans or your attorney has the final word. We don't guarantee approval, a contract or a date.

Want accreditation in the same project? Program Launch + Accreditation is $54,500. Or book a free 30-minute call and we'll walk through what New York will ask of you.

Cima Consulting isn't a law firm or an accounting firm. New York agencies make their own decisions; we don't guarantee approvals, rates or dates. Never pay or accept anything of value for patient referrals: New York's law and federal law (EKRA and the Anti-Kickback Statute) both apply.

Sources

• 14 NYCRR Part 810, establishment, incorporation and certification: Justia (810.1); proposed amendments: OASAS, December 2025 summary
• 14 NYCRR Part 822: 822.3, 822.5 (Justia); Part 822 Clinical Standards overview
• Full review and the council: BHSAC OASAS projects, December 10, 2025; OASAS certification process presentation (December 2022); Project Review Committee minutes, October 2023
• CASAC: OASAS CASAC page; application instructions and forms; renewal
• Medicaid: OASAS APG Manual; calculating APG rates; COP: MetroPlusHealth notice
• Patient brokering: A7689-A; Assemblymember Rosenthal; OASAS Stop Treatment Fraud
• CMS, CY 2024 outpatient rule: cms.gov; EKRA, 18 U.S.C. 220: Cornell LII

Comparing states? See Texas and our guides for Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, Washington, West Virginia and Wisconsin, or how to start an IOP for what every state has in common.