How to get a Texas chemical dependency treatment facility license

Who needs the license

In Texas, a program that treats substance use disorders must hold a chemical dependency treatment facility (CDTF) license from the Texas Health and Human Services Commission (HHSC) before it provides treatment. That covers outpatient, intensive outpatient (IOP), partial hospitalization (PHP) and residential programs. The license belongs to the program (the legal entity at a site), not to any one clinician.

• You need it if you'll run an SUD program: admitting clients, building a treatment plan and providing counseling, education groups and discharge planning as a program, whether clients pay with insurance, Medicaid or cash.
• Faith-based programs that use only nonmedical treatment and recovery methods have their own path under Health and Safety Code chapter 464, subchapter C, and 26 TAC 564 subchapter O. They're exempt from the CDTF license but have their own requirements.
• Mental-health-only programs don't fit this license: a CDTF client must meet DSM criteria for a substance use disorder (26 TAC 564.801(a)). If you're planning a mental health IOP or PHP, read which license applies to a mental health IOP or PHP in Texas.
• Sober living homes that provide no treatment aren't CDTFs. See how to open a sober living home in Texas.

If your model sits on a line (a solo LCDC practice that wants to add groups, a co-occurring program, a telehealth-only program), ask HHSC in writing before you sign a lease, and keep the reply.

The law and the rules

• The statute: Texas Health and Safety Code chapter 464 sets up CDTF licensing. Under section 464.004 a license expires two years after it's issued.
• The rules: 26 TAC chapter 564, "Chemical Dependency Treatment Facilities." HHSC moved these rules from 25 TAC chapters 441 and 448 to 26 TAC chapter 564 effective April 30, 2024. The section numbers carried over (25 TAC 448.804 became 26 TAC 564.804), and the text didn't change in the move, so some sections still refer to the old numbers and to "TCADA," the agency HHSC replaced.
• Licensure is in subchapter D: the new application is 564.403, changes to a license are 564.405, inspections are 564.407, and fees are 564.408. The operational plan and policies are 564.502.

Forms lag the rules. HHSC's Form 3207 instructions (last revised November 2022) still cite 25 TAC 448.401 and 448.403. Read those as 26 TAC 564.401 and 564.403. For a plain-English map of the whole chapter, see our 26 TAC 564 requirements guide.

Before you file: what has to be true

Most people file too early and run out the clock (see the 6-month rule). In the roadmap we run for an IOP / PHP program launch, the HHSC application step is locked until six others are finished: the lease, the policy manual, the rule-by-rule check against 26 TAC 564, the program's insurance, the governing body and the leadership team. File when these are done, or a few weeks from done:

1. The entity exists with the Texas Secretary of State, with an EIN, and the legal name matches, letter for letter, across the formation certificate, IRS letter, insurance certificates, lease and application.
2. The site is secured in the company's name, the city has confirmed in writing that a treatment program is allowed there, and the build-out is on track for a certificate of occupancy and fire marshal sign-off.
3. Leadership is named: the governing body, the program director and the clinical leadership. Under 564.901(o), the people who plan, direct or supervise treatment are qualified credentialed counselors (QCCs), and the clinical program director has two or more years of post-licensure chemical dependency treatment experience.
4. The policy manual is written and checked rule by rule against 26 TAC 564, and the governing body has adopted it.
5. Liability insurance is bound for the organization, and you have the certificate.
6. Staff are lined up, with credential files and the required training planned. 564.603 sets training hours, for example 8 hours (including 2 hours on DSM criteria) for staff who screen or authorize admissions, completed before they do it.

The forms and the application packet

HHSC's CDTF provider page lists the current forms. For a new license:

Other forms you may meet: Form 3256 (CDTF variance request) if you need HHSC to approve an alternative way of meeting a rule, and Form 3248 (counselor intern registration) for counselor interns on your team. Under 564.403 you also display the license certificate at each outpatient location.

What goes in the operational plan

26 TAC 564.502 ("Operational Plan, Policies and Procedures") is the rule; read its current text before you write. A plan that gets through review reads like your actual program, not a template. Ours cover:

• Who runs it: the legal entity, owners, the governing body and how it meets, the organization chart, and the program director's authority.
• What you provide: each level of care (outpatient, IOP, PHP), adults or adolescents, the hours and days, the services in each (individual counseling, process groups, chemical dependency education, life skills), and any medication services.
• Who you serve and how they get in: screening, the QCC's written admission authorization naming the level of care, admission and exclusion criteria, and how you refer people you can't serve.
• The clinical path: assessment within 3 individual service days, the treatment plan within 5, plan reviews at least by the midpoint of the projected stay, discharge planning, the discharge summary and follow-up. (Timelines from 564.803, 564.804 and 564.805; the details.)
• Staffing: positions, credentials, QCC coverage and supervision of counselor interns, ratios, and training.
• The policies the governing body adopts, including client rights and abuse, neglect and exploitation (ANE), which 564.502 calls out; records and confidentiality (42 CFR Part 2); emergencies; incidents; quality and utilization review.
• The site: address, rooms, record storage, and how the space supports group sizes (564.901(b) caps counseling groups at 16 clients and education groups at 35).

Keep the plan and the manual in step. A surveyor who reads "assessment within 72 hours" in one and "within 3 service days" in the other will ask which one staff follow.

Fees

The fee schedule is in 26 TAC 564.408:

So a single-site outpatient program pays $1,200 for a two-year license, plus $125 for each additional site. The rule asks for payment in full by cashier's check or money order, and a facility owes the full fee for any licensure period in which it provides treatment. Fees change: confirm the current amount and how HHSC takes payment before you send it. Your other costs (attorney, build-out, insurance, the certificate of occupancy) are usually far larger than the license fee.

The 6-month rule and HHSC's deadlines

26 TAC 564.403 sets the clock on both sides:

The 6-month window is the one that hurts. If construction slips, the fire marshal can't come, or your program director quits, the clock keeps running. A denied applicant starts over with a new application and a new fee. That's why we file only when the site, policies and staff files are close to ready.

Two more rules from 564.403: you may not provide chemical dependency treatment until HHSC gives written notice of approval, and the license certificate is displayed at each location. Don't schedule a first admission, or tell referral sources you're open, before that notice.

The inspection: what HHSC looks at

Under 564.407, surveyors may inspect on a scheduled or unannounced basis, must be given access to all records, and may interview clients and staff. For a new program with no clients yet, expect the review to center on whether you're ready to operate by the rules:

• The site: the certificate of occupancy and fire inspection, locked record storage, posted client rights, the HHSC complaint information and the grievance procedure (564.506 asks for them in English and a second language).
• Governance and policies: governing body minutes adopting the operational plan and policies, and policies that actually match 26 TAC 564.
• Personnel files: licenses verified, QCC status (an LCDC, or certain other Texas licensees with at least 1,000 hours of documented substance use treatment experience, under 564.1), counselor intern registration and supervision, job descriptions, and the training 564.603 requires with dates.
• Your forms: the consent to treatment with all the elements 564.802(b) lists, the client bill of rights with HHSC's contact information (564.701), the grievance procedure (564.702), screening, assessment, treatment plan, progress note and discharge forms that capture what the rules require.
• Emergency and incident procedures: medical and psychiatric emergencies (564.707), incident reporting within 24 hours (564.509), and ANE reporting to HHSC (564.703).

Once you're open, later surveys read charts: a QCC-signed assessment within 3 service days, a plan within 5, notes within 72 hours, reviews by the midpoint, discharge summaries within 30 days. Our 26 TAC 564 map lists each requirement with the document that proves it. Our sister product publishes a chart audit checklist for practicing that read.

Why applications stall

What we see slow applications down, and how to avoid each one:

• Names that don't match. The entity name on Form 3207, the Secretary of State filing, the IRS letter, the insurance certificate and the lease must be identical. "Clinic LLC" against "Clinic, LLC" earns a deficiency letter.
• Filing before the building is ready. No certificate of occupancy or fire sign-off means no inspection, while the 6-month clock runs.
• A template operational plan that describes services, hours or levels of care you don't offer, or contradicts your own policies.
• Policies that don't track the rule. A consent form missing some of the 564.802(b) elements, a bill of rights still listing TCADA instead of HHSC, a grievance policy without the 7-day written response (564.702(e)).
• Leadership that doesn't qualify. A clinical program director without two years of post-licensure chemical dependency experience, or a non-LCDC counted as a QCC without documented 1,000 hours.
• Staff training not done or not dated. Training must be finished before staff perform the duty, with sign-in sheets in the file.
• The wrong payment form, or a fee for the wrong number of sites.
• Slow answers. When HHSC asks for something, answer completely, in writing, fast. Every week you take comes out of your 6 months.

After the license

• Changes need approval first. Under 564.405, a facility submits the application and fees and gets written approval before adding or moving a residential site, and HHSC processes a move to a new address as a new site. Before opening a second outpatient location, changing ownership or adding a level of care, ask HHSC which form and fee apply.
• Renew on time. The license runs two years (Health and Safety Code 464.004). Put the expiration on the calendar 120 days out.
• Watch the rule changes. In the July 10, 2026 Texas Register, HHSC proposed amending 564.603 to allow abuse, neglect and exploitation training by live, instructor-led video, after SB 437 changed the law. Check whether it's been adopted before you change your training.
• Then the money: facility credentialing with each insurance plan usually starts once the license is issued, because plans ask for the license with the application. The program launch package includes facility contracts with 8 plans; already licensed, see facility credentialing by the plan. For everything around the license, read the full guide to starting an IOP or PHP in Texas.
• Keep one inspection binder with the license, the certificate of occupancy and fire report, governing body minutes, the policy manual, staff files and training sign-ins. Surveys can be unannounced (564.407), so it lives at the site, not in someone's inbox.

Timeline

Where the license sits in a full program launch, on our Texas roadmap for an SUD program:

From the kickoff, on the earliest path through our 118-step Texas roadmap. Agencies and insurance plans set their own pace, so treat these as typical, not promised.

The government and third-party fees on that roadmap:

Already have a manual? The program policy and procedure manual is $4,500 on its own, with a state-rule crosswalk. Or book a free 30-minute call and we'll tell you honestly how close you are to filing.

Questions

Sources

• Texas Health and Safety Code chapter 464 and section 464.004 (two-year license)
• 26 TAC 564.403, new licensure application; 564.405; 564.407; 564.408, fees
• 26 TAC chapter 564, all subchapters (Cornell LII)
• HHSC: Chemical Dependency Treatment Facilities
• HHSC Form 3207, Form 3208, Form 3256
• Texas Register: transfer of the rules to 26 TAC 564, effective April 30, 2024
• Texas Register, July 10, 2026: proposed amendment to 26 TAC 564.603

Cima Consulting isn't a law firm and doesn't give legal advice. HHSC decides every application; no one can promise an approval or a date.