Can an LCDC open a private practice in Texas?

The short answer

A fully licensed LCDC can open a private practice in Texas and provide substance use counseling to clients personally, in their own office or by telehealth, without a facility license. Texas requires a chemical dependency treatment facility license from HHSC for anyone who offers chemical dependency treatment, but the statute exempts an individual who personally counsels people with chemical dependency and doesn't offer a treatment program, and the private office of a licensed practitioner who personally provides services within their license (Texas Health and Safety Code chapter 464). The practical limits:

• Offer counseling, not a program. Once you advertise or run a structured treatment program (an IOP, a PHP, a set schedule of groups and sessions clients enroll in), you need the HHSC facility license.
• Insurance is plan by plan. Medicare doesn't enroll LCDCs as independent providers, and many commercial plans credential only master's-level licenses for therapy. Some plans do credential LCDCs for substance use services; check each plan.
• LCDC interns can't open their own practice. A counselor intern practices under a qualified supervisor.

For the business side every Texas practice shares (the entity, NPIs, CAQH, malpractice, HIPAA, fees), see how to start a private practice in Texas. This guide covers what's different for LCDCs.

1. What the LCDC license covers

• HHSC licenses LCDCs, not the Behavioral Health Executive Council that licenses LPCs, LMFTs and LCSWs. Keep your license active and your continuing education current, and look yourself up on HHSC's license search the way a plan's credentialing team will.
• It's a substance use license. The LCDC license covers chemical dependency counseling (Texas Occupations Code chapter 504). It isn't a general mental health license: treating depression, anxiety or trauma on their own needs a license that covers them, such as an LPC or LCSW. Read the current scope in chapter 504 and HHSC's counselor rules before you advertise a service.
• Many LCDCs hold a second license. An LCDC who is also an LPC, LCSW or LMFT can offer both kinds of care and is credentialed by plans under the master's-level license. That one fact changes your payer list more than anything else on this page.
• Counselor interns (LCDC-I) counsel only under supervision as HHSC's rules require, and generally can't be credentialed with insurance plans or open a practice of their own.

2. Practice or program: when you need a facility license

This is the line that matters most. The test in the statute is whether you offer chemical dependency treatment as a program, not how many clients you see. When in doubt, ask HHSC's licensing staff in writing before you open or advertise.

What you're doing	Facility license?
You personally counsel individual clients in your office or by telehealth	Generally no: that's the exemption for individual counseling and a practitioner's own office.
You run a counseling group you lead yourself, within your license	Ask HHSC first. The office exemption covers services you personally provide in your office, but a recurring group that looks like a program is where the line gets close.
You hire or contract other counselors to provide substance use counseling under your practice	Ask HHSC and your attorney first. The exemptions describe services a practitioner provides personally.
You offer an intensive outpatient or partial hospitalization program, or any structured treatment program	Yes: an HHSC chemical dependency treatment facility license, under the rules in 26 TAC chapter 564. See how to start an IOP or PHP in Texas.
You want to provide withdrawal management or residential treatment	Yes, with the services those levels require, plus medical staff.
You want to open a sober living home	A recovery residence that provides no treatment isn't licensed as a treatment facility in Texas. See how to open a sober living home in Texas.

Calling it a "practice" doesn't change what it is. If your website lists a schedule of groups clients attend several days a week, a plan or a surveyor will read it as a program, and so may HHSC.

3. Services an LCDC practice can offer

• Substance use assessments, including the ones courts, employers, schools or probation ask for, when the person asking will accept an LCDC's assessment. Find out what they need in the report before the appointment.
• Individual counseling for alcohol and drug use: motivational work, relapse prevention, coping skills, and the treatment plan that ties it together.
• Family sessions about the client's substance use, with the client's written consent.
• Continuing care after a program: step-down counseling for clients leaving an IOP or residential stay. Programs need somewhere to send people, so this is a natural source of clients. Build those relationships on good care and communication, and never give or accept anything of value for referrals (Texas Patient Solicitation Act).
• Telehealth to clients located in Texas, on a video platform that signs a business associate agreement, with a telehealth consent.
• Referral, not treatment, for what's outside your scope: withdrawal that needs medical care, medications for addiction, psychiatric symptoms. Keep a short list of prescribers, programs and therapists you trust.

4. Which payers credential LCDCs

This varies more than for any other license, and it changes, so check each plan before you build your practice around it. On each call or in each application, ask:

1. Does the plan have a provider type for a licensed chemical dependency counselor in Texas, and is the panel open in your county?
2. Which codes will it pay an LCDC for? Plans that pay for substance use counseling often use HCPCS codes such as H0001 (alcohol and drug assessment), H0004 (individual counseling, per 15 minutes) and H0005 (group counseling); others pay only the CPT psychotherapy codes, and only to master's-level clinicians.
3. Does it require a master's degree, a second license, or an affiliation with a licensed facility?
4. Does its behavioral health benefit go through another company? Many Texas plans carve behavioral health out to a manager; the carve-out guide explains how to tell.

Payer	LCDC on its own	What to do
Medicare	No: Medicare doesn't enroll LCDCs as independent providers	If you're also an LPC, LMFT or LCSW, enroll under that license (CMS).
Texas Medicaid and its managed care plans	Don't assume so	See Medicaid below; ask TMHP and each plan in writing.
Commercial plans (Blue Cross and Blue Shield of Texas, Aetna, Cigna, UnitedHealthcare and their behavioral health managers)	Some do, for substance use services; some don't	Check each plan's current provider types and codes before you apply.
Employee assistance programs	Varies	Ask each EAP network what licenses it accepts.
Self-pay, courts and employers	Yes	Set clear fees and give self-pay clients a good faith estimate before services (CMS).

Many LCDC practices open self-pay and add the plans that turn out to take them. Our credentialing service checks each plan's rules for your license before we file, so you don't pay for an application a plan will refuse.

5. Medicaid and Medicare

• Texas Medicaid enrollment goes through TMHP, and most Texas Medicaid clients are in managed care plans that each credential separately. Substance use treatment programs enroll as licensed chemical dependency treatment facilities. Whether a solo LCDC practice can enroll, and for which services and codes, is a question to put to TMHP and each Medicaid managed care plan in writing before you plan on Medicaid revenue.
• Medicare began paying licensed mental health counselors and marriage and family therapists on January 1, 2024 (CMS), but an LCDC license on its own doesn't qualify you. Medicare clients need a Medicare-eligible clinician or program.
• If you take Medicaid or Medicare clients in any role, check yourself and anyone you hire against the federal OIG and Texas Medicaid exclusion lists.

6. Opening steps that are different for LCDCs

• NPI taxonomy. When you get your free individual NPI from NPPES, pick the taxonomy that matches the LCDC license, Addiction (Substance Use Disorder) Counselor, 101YA0400X. If you also hold a master's-level license, ask your credentialing help which to list as primary.
• Entity. A professional LLC is formed for a licensed professional service; confirm with your attorney that the entity type fits your license before filing with the Texas Secretary of State.
• 42 CFR Part 2. A practice that holds itself out as treating substance use disorders and is federally assisted (Medicare, Medicaid or a DEA registration all count) must protect those records under 42 CFR Part 2; the updated rule's compliance date was February 16, 2026. Use Part 2 consent and release language either way; it's what clients and programs expect.
• Assessment and plan templates built for substance use: a structured assessment that supports the diagnosis and the recommendation, a treatment plan with measurable goals, progress notes tied to those goals, and a discharge summary.
• A crisis procedure, including overdose: when you call 988, a mobile crisis team or 911, and whether you keep naloxone in the office.

Those are the same steps as any solo practice, in the same order, plus the payer checks above. Our Solo Practice Launch runs them on a dated roadmap: NPIs, CAQH, three plans chosen from the ones that actually take LCDCs in your area, and the policies and client forms with Part 2 language, under your practice's name.

7. Growing into a group or a program

Many outpatient programs in Texas started as one counselor's practice. If you're heading that way:

• A group practice with therapists and prescribers can offer more than one license's services and contract as a group. See how to start a group practice in Texas, and ask HHSC first if the group will provide substance use counseling by several counselors.
• A licensed program (outpatient, IOP or PHP) needs the HHSC facility license, a site that can pass inspection, a policy manual and qualified credentialed counselors. Under 26 TAC 564, a QCC is an LCDC, or certain other Texas-licensed professionals (such as an LPC, LMSW, LMFT, psychologist, physician, PA or psychiatric advanced practice nurse) with at least 1,000 hours of documented substance use treatment experience (26 TAC 564.1). Your LCDC is exactly what a program needs.
• An EHR that grows with you. Cima EHR for addiction counselors has substance use intake (H0001 or 90791), treatment plans and Part 2 releases on the Solo plan, and the same chart grows into levels of care, group notes and per diem billing on the Program plan.

Planning a licensed program instead? See the IOP / PHP Program Launch. Or book a free 30-minute call and we'll tell you which side of the line your plan is on.

Questions

Can an LCDC have a private practice in Texas?

Yes. A fully licensed LCDC can provide substance use counseling personally in a private practice without a facility license, because Texas exempts individuals who personally counsel people with chemical dependency and don't offer a treatment program. Offering an IOP, PHP or other structured program requires an HHSC facility license.

Can an LCDC bill insurance?

Sometimes. Medicare doesn't enroll LCDCs as independent providers, and Texas Medicaid and many commercial plans have their own rules. Some commercial plans credential LCDCs for substance use services. Check each plan's provider types and the codes it pays an LCDC for before applying.

Can an LCDC treat depression or anxiety?

The LCDC is a substance use license. Treating mental health conditions on their own needs a license that covers them, such as an LPC or LCSW. Read the current scope in Texas Occupations Code chapter 504 and HHSC's rules.

Can an LCDC intern open a private practice?

No. A counselor intern counsels under supervision as HHSC's rules require, and generally can't be credentialed with insurance plans. Plan to work in a program or under a qualified supervisor until you're fully licensed.

Do I need a facility license to run groups?

If the groups are part of a structured treatment program, yes. A group you lead yourself in your own office may fall under the practitioner's office exemption, but it's close to the line. Ask HHSC in writing before you start or advertise groups.

Sources

• Texas Legislature, Health and Safety Code chapter 464 (license required, §464.002; exemptions, §464.003)
• Texas Legislature, Occupations Code chapter 504 (chemical dependency counselors)
• 26 TAC §564.1, definitions, including qualified credentialed counselor (Cornell LII)
• CMS, Marriage and family therapists and mental health counselors
• TMHP, Texas Medicaid provider enrollment
• CMS, No Surprises Act; eCFR, 42 CFR Part 2
• Texas Legislature, Occupations Code chapter 102 (Patient Solicitation Act)