How to start an IOP or PHP in Killeen–Temple

Killeen–Temple at a glance

Question	Bell County's answer
State license	HHSC chemical dependency treatment facility license for each site (26 TAC 564)
Medicaid service area	MRSA Central (the rural Central service area), including Bell, Coryell, McLennan, Brazos and about two dozen more counties
STAR plans	Superior HealthPlan, Wellpoint (RightCare left August 31, 2026)
STAR+PLUS plans	Superior HealthPlan and UnitedHealthcare publish MRSA Central STAR+PLUS networks; confirm the current list on HHSC's map
Local mental health authority	Central Counties Services (Temple): Bell, Coryell, Hamilton, Lampasas and Milam counties
Permits and certificate of occupancy	City of Killeen Building Inspections; Temple, Harker Heights, Copperas Cove and Belton each have their own
Military and veterans	TRICARE West through TriWest (accreditation required for IOP and PHP); VA Community Care

Medicaid line-ups from HHSC's MRSA Central STAR comparison chart (September 1, 2026) and the plans' MRSA Central STAR+PLUS directories; counties from UnitedHealthcare's MRSA Central STAR+PLUS directory. Check HHSC's managed care service areas map before you apply.

The state license

Under Health and Safety Code chapter 464 and 26 TAC chapter 564, HHSC licenses the program as a chemical dependency treatment facility before it treats anyone; no Bell County city adds a treatment license. As of October 2026 the fee under 26 TAC 564.408 is $1,200, plus $125 per additional site.

Decide early whether you're building for TRICARE. If you are, the license is step one of two: you'll also need accreditation, and an accreditor won't survey a program until it has clients and charts. Write your policies to the accreditor's standards from the start so you don't rewrite them six months in. The forms are in our Texas CDTF license guide; the proof list is 26 TAC 564 in plain English; the full sequence is how to start an IOP or PHP in Texas; and the survey side is in accreditation for new programs.

Permits: Killeen, Temple and the towns between

Bell County's cities each run their own building office, so confirm which one has your address. Killeen publishes an unusually clear process on its Building Inspections page:

• No opening without a certificate. Killeen says it's unlawful to open a place of business without first getting a certificate of occupancy. As of October 2026 the application fee is $90 plus a $10 technology fee.
• New owner, name, tenant or use means a new certificate. If you rename the program, take over another provider's space, or change how the space is used, apply again. That catches buyers of existing practices too.
• Every department inspects first. The building department issues the certificate only after all departments pass their inspections. A temporary certificate is available on written request to the building official, which can help if a minor item holds up an otherwise ready site.

Temple, Harker Heights, Copperas Cove and Belton have their own permit offices and rules. Ask whichever office has jurisdiction, in writing, before you sign:

1. What occupancy classification does an outpatient substance use treatment program with group rooms fall under at this address?
2. Does the current certificate of occupancy cover our use and headcount, or do we apply for a new one?
3. What permits and inspections does the build-out need, and which departments inspect before the certificate?
4. What will the fire marshal check before we open?

Then lease with a contingency for the certificate of occupancy and the HHSC license, plus free rent during the build-out. Every site step is in our Texas IOP opening checklist.

Medicaid plans in MRSA Central

Bell County isn't a metro service area in HHSC's system; it's part of the rural Central area, which stretches from Brazos to Comanche. After the HHSC license, enroll with TMHP and credential with each plan; TMHP has said Medicaid SUD treatment may only be delivered in a licensed chemical dependency treatment facility (TMHP notice).

Program	Who it covers	Plans in MRSA Central
STAR	Most children, pregnant women and some families	Superior, Wellpoint
STAR+PLUS	Adults with disabilities and adults 65 and older	Superior and UnitedHealthcare publish networks here; confirm on HHSC's map
CHIP and STAR Kids	Children above Medicaid income; children with disabilities	Check HHSC's current map

• RightCare is gone. Scott and White Health Plan's RightCare was the local STAR plan in this area. Baylor Scott & White Health Plan said it would leave Texas Medicaid managed care on August 31, 2026 (KWTX), and HHSC's September 2026 chart lists only Superior and Wellpoint. Members moved, so ask new clients which card they carry now. Our Baylor Scott & White Health Plan guide covers what that means for providers.
• Superior first. Superior is in both STAR and STAR+PLUS here, so it's the natural first application for an adult program (Superior HealthPlan guide).
• Wellpoint's rural network runs through MultiPlan. In the Medicaid rural service areas Wellpoint contracts through MultiPlan's Texas True Choice network (Wellpoint Texas guide).
• UnitedHealthcare's behavioral health runs through Optum (UnitedHealthcare and Optum guide).

The filing order is in our Texas Medicaid credentialing guide; ask each plan whether it pays adult PHP and IOP as an in-lieu-of service (Texas Medicaid IOP and PHP guide). Our credentialing service files and follows every application.

Fort Hood and TRICARE

The post was renamed Fort Cavazos in May 2023, and in 2025 the Army restored the name Fort Hood, now honoring Col. Robert B. Hood, a World War I Distinguished Service Cross recipient (NBC DFW). Whatever the sign says, Carl R. Darnall Army Medical Center and a large population of soldiers, families and retirees make TRICARE a real part of this market.

• TRICARE West, through TriWest. Since January 1, 2025, Texas has been in TRICARE's West region, so civilian programs join the network through TriWest Healthcare Alliance (TRICARE).
• Accreditation is required. TRICARE pays an IOP or PHP only under a participation agreement that requires accreditation (TRICARE Policy Manual, IOP participation agreement). Programs usually use the Joint Commission, CARF or COA; confirm the accepted list with TriWest. Because a new program can't be surveyed before it has clients, most open with commercial and Medicaid clients, get accredited, then add TRICARE. Our Joint Commission vs CARF comparison helps you choose.
• Know who needs a referral. Active-duty soldiers' care is normally coordinated through the military hospital, and TRICARE plans differ on referrals and authorizations for family members and retirees. Ask TriWest what each beneficiary category needs before the first admission, and verify each client's benefits.

The TRICARE application itself is in our TRICARE credentialing guide, and the Program Launch + Accreditation package carries a program through its survey.

Veterans and the Central Texas VA

Retirees and veterans live across Bell County, and the Central Texas VA health care system is headquartered in Temple. Veterans the VA sends to community providers come through the Community Care Network, a separate contract from TRICARE; being in one doesn't put you in the other. Our VA Community Care guide covers the network, the referral and authorization, and billing. Military and veteran clients often carry more than one coverage (TRICARE, VA, Medicare or an employer plan), so sort out who pays first before admission.

The local landscape

Earn referrals with quick assessments and honest level-of-care calls. Paying or giving anything of value for referrals is illegal under the Texas Patient Solicitation Act and federal EKRA (patient brokering laws, explained). We never arrange referrals.

• Central Counties Services, based in Temple, is the local mental health authority for Bell, Coryell, Hamilton, Lampasas and Milam counties (HHSC's authority locator). Agree how crisis hand-offs work and where to send clients who need public services.
• OSAR. HHSC funds Outreach, Screening, Assessment and Referral programs in every region (HHSC OSAR page); find the current Central Texas provider there.
• Hospitals. Temple's large medical center, Killeen's hospitals and Darnall discharge patients who need a step-down level of care. Their case managers want your levels of care, accepted plans (including TRICARE status) and assessment times.
• Courts and probation. Drug courts run under Government Code chapter 123 and veterans treatment courts under chapter 124; reports go only with consent that meets 42 CFR Part 2.
• Military family support and veteran organizations often know who needs help. Give them your schedule, levels of care and coverage; legal marketing is in how to market a treatment center.

The order of work in Killeen–Temple

Step	Bell County detail	Typical time in our roadmap
1. Program model and budget	Decide on TRICARE now; budget the accreditation survey. Use the break-even calculator.	1–2 months
2. Site search	Which city has the address; the four questions above	about 30 days
3. Lease with a contingency	Out if the certificate of occupancy or license fails; free rent for the build-out	about 3 weeks
4. Build-out	Permits from the city with jurisdiction	about 6 weeks
5. Certificate of occupancy and fire inspection	All departments pass, then the certificate (Killeen)	about 3 weeks
6. HHSC license and inspection	File when the site, policies and staff files are nearly ready	about 2–3 months
7. Facility contracts	TMHP, Superior, Wellpoint (MultiPlan), commercial plans, VA Community Care	about 90 days each
8. Accreditation, then TRICARE	Survey once you have clients and charts; then the TriWest participation agreement	after opening

The times are planning figures from our own launch roadmap, not promises. What it costs is in how much it costs to start an IOP and accreditation cost and timeline.

Or book a free 30-minute call about your plans.

Questions

Can a Killeen IOP take TRICARE patients from Fort Hood?

Yes, once it meets TRICARE's rules: a participation agreement through TriWest and accreditation for IOP and PHP programs. Most new programs open, get accredited once they have clients and charts, then contract with TRICARE.

Is it Fort Hood or Fort Cavazos?

Fort Hood. The post was renamed Fort Cavazos in May 2023, and the Army restored the name Fort Hood in 2025, now honoring Col. Robert B. Hood. Payer and VA documents may use either name.

Which Medicaid plans serve Bell County after RightCare left?

HHSC's September 1, 2026 chart for MRSA Central lists Superior and Wellpoint for STAR. Superior and UnitedHealthcare publish MRSA Central STAR+PLUS networks. Confirm the current line-up on HHSC's map before you apply.

Does Killeen require a new certificate of occupancy if I take over a practice?

Yes. Killeen requires a new certificate of occupancy for a change of owner, business name, tenant or use, and it's unlawful to open without one.

Who is the local mental health authority in Bell County?

Central Counties Services, based in Temple, which serves Bell, Coryell, Hamilton, Lampasas and Milam counties.

Other Texas cities: Austin, San Antonio, El Paso (another TRICARE market), and every city guide on opening a program in Texas, by city.

Cima Consulting isn't a law or accounting firm. HHSC, the cities, TriWest, the VA and each health plan make their own decisions; we don't guarantee approvals, rates or dates. We aren't affiliated with any health plan or government program named here.

Sources

• HHSC, STAR comparison chart, MRSA Central (September 1, 2026): hhs.texas.gov; Managed Care Service Areas map: hhs.texas.gov
• UnitedHealthcare, STAR+PLUS provider directory, MRSA Central (counties): uhc.com; Superior HealthPlan, STAR+PLUS service areas: superiorhealthplan.com
• KWTX, Baylor Scott & White Health Plan to exit Texas Medicaid managed care, April 15, 2026: kwtx.com
• City of Killeen, Building Inspections: killeentexas.gov; certificate of occupancy guidance: killeentexas.gov
• NBC DFW, Fort Cavazos to revert to Fort Hood (2025): nbcdfw.com
• TRICARE: tricare.mil; TRICARE Policy Manual, IOP participation agreement: manuals.health.mil
• HHSC, find your local mental health authority: hhs.texas.gov; HHSC OSAR: hhs.texas.gov
• TMHP, substance use disorder benefit changes: tmhp.com; Texas Health and Safety Code chapter 464: statutes.capitol.texas.gov; 26 TAC 564.408: justia.com
• Texas Occupations Code chapter 102: statutes.capitol.texas.gov; EKRA: law.cornell.edu; Government Code chapters 123 and 124: ch. 123, ch. 124; 42 CFR Part 2: ecfr.gov