How to start an IOP or PHP in Laredo

Laredo at a glance

Question	Laredo's answer
State license	HHSC chemical dependency treatment facility license for each site (26 TAC 564)
Medicaid service area	Hidalgo: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy and Zapata counties
STAR plans	Driscoll Health Plan, Molina, Superior HealthPlan, UnitedHealthcare Community Plan
STAR+PLUS plans	Molina, Superior HealthPlan, UnitedHealthcare Community Plan (confirm on HHSC's map)
CHIP	Molina, Superior HealthPlan
Local mental health authority	Border Region Behavioral Health Center: Jim Hogg, Starr, Webb and Zapata counties
Permits and certificate of occupancy	City of Laredo Building Development Services; Webb County outside city limits
Local watch-outs	Spanish-language services; clients who live in Mexico; CDL drivers under federal testing rules; a certificate that ends when the business changes

Counties from HHSC's STAR+PLUS service area by county appendix (revised June 2026); plans from HHSC's managed care service areas map. Line-ups change with HHSC's contracts; check them before you apply.

The state license

HHSC licenses Texas substance use programs as chemical dependency treatment facilities under Health and Safety Code chapter 464 and 26 TAC chapter 564, and Laredo adds no separate treatment license. As of October 2026 the fee under 26 TAC 564.408 is $1,200 plus $125 for each additional site.

One Laredo-specific habit: write your policies, consents and client materials in English and Spanish before you file, not after. The rules require some postings in two languages (below), HHSC's surveyors will read your intake packet, and fixing it later means reprinting everything. 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.

Laredo's certificate of occupancy

Inside the city, City of Laredo Building Development Services handles permits and certificates of occupancy. Its published requirements have several details a new program should plan around:

• Four sign-offs. A new business's certificate of occupancy needs approval from the zoning, building and right-of-way divisions and the environmental engineer. Once the reviews are done, any required fixes are made and fees are paid, the building official issues it.
• It doesn't survive changes. The city code says the certificate isn't transferable and must be displayed in the business, and a change in ownership, business name, type of business, use of the structure or site plan terminates it. If you buy an existing program, rename after opening, or add a level of care that changes how the space is used, ask whether you need a new certificate, and update HHSC too (see buying a treatment center).
• Current code, registered contractor, electronic plans. The city says new projects must comply with the 2021 building code, an active general contractor registration is required for a permit, and commercial plans are submitted electronically.

Addresses outside city limits go through Webb County. Ask in writing before you sign:

1. Is an outpatient substance use treatment program allowed in this zoning district at this address?
2. Does the existing certificate of occupancy cover our use and headcount, or do we need a new-business certificate?
3. What will zoning, building, right-of-way and the environmental engineer each need from us?
4. What will the fire marshal check before we open?

Then lease with a contingency for the certificate and the HHSC license, plus free rent during the build-out. All the site steps are in order in our Texas IOP opening checklist.

Medicaid plans in the Hidalgo service area

HHSC groups Webb County with the Rio Grande Valley and the counties between, so Laredo's Medicaid plans are the Valley's. 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 the Hidalgo service area
STAR	Most children, pregnant women and some families	Driscoll, Molina, Superior, UnitedHealthcare
STAR+PLUS	Adults with disabilities and adults 65 and older	Molina, Superior, UnitedHealthcare (confirm on the map)
CHIP	Children in families above Medicaid income	Molina, Superior
STAR Kids	Children and young adults with disabilities	Check HHSC's current map

• Adult program? Molina, Superior and UnitedHealthcare appear in both STAR and STAR+PLUS here, so they're the usual first three. Molina manages behavioral health itself (Molina Texas guide); UnitedHealthcare's behavioral health runs through Optum, which is a separate contracting conversation (UnitedHealthcare and Optum guide).
• Adolescent program? Driscoll Health Plan, a children's plan based in Corpus Christi, is a STAR option here alongside Superior and Molina, which are also the CHIP plans.
• Ask about in-lieu-of services for adult PHP and IOP before counting on Medicaid revenue; see our Texas Medicaid IOP and PHP guide.

The filing order is in our Texas Medicaid credentialing guide. Commercial contracts are covered in insurance contracts for treatment centers, and our credentialing service files and follows every application.

Border, bilingual and trucking questions

• Serve clients in Spanish. Under 26 TAC 564.506 the client bill of rights, HHSC's complaint information and the grievance procedure are posted in English and a second language. In Laredo, go further: bilingual counselors or a written interpreter policy, Spanish intake packets and consents, and Spanish-language groups if demand supports them. Groups need one language per session that every member understands; plan the schedule around it.
• Clients who live in Mexico. Texas Medicaid covers Texas residents, and a client living in Nuevo Laredo usually won't have coverage you can bill. Set a written self-pay policy and fee schedule, verify any US coverage a client carries before admission (our sister site's VOB checklist lists what to ask), and plan how you'll handle aftercare across the border.
• Records across the border. Sending records to a provider in Mexico still needs a consent that meets 42 CFR Part 2 for SUD records, in a language the client understands.
• CDL drivers. Laredo is a major commercial port of entry, and many residents drive trucks or work in logistics. Commercial drivers who violate federal testing rules go through a substance abuse professional (SAP) evaluation and treatment before a return-to-duty test, and employers check FMCSA's Drug and Alcohol Clearinghouse. Your program may provide the treatment a SAP recommends; report to the SAP only with Part 2 consent, and keep SAPs with a financial tie to you out of your referral flow, as 49 CFR Part 40, Subpart O generally requires.

The local landscape

Earn referrals with quick, bilingual 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.

• Border Region Behavioral Health Center is the local mental health authority for Webb, Zapata, Jim Hogg and Starr counties and runs the area's crisis line (HHSC crisis services guide). 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 each region to link people to state-funded substance use treatment (HHSC OSAR page). Find the current provider for Webb County there.
• Hospitals discharge patients who need a step-down level of care; their case managers want your levels of care, accepted plans, languages and assessment times.
• Courts and probation. Specialty courts, including drug courts, run under Government Code chapter 123; court reports go only with Part 2 consent.
• Employers and EAPs, especially in logistics, refer workers who need more than weekly therapy. Legal marketing, including Spanish-language directories and ads, is in how to market a treatment center.

The order of work in Laredo

Step	Laredo detail	Typical time in our roadmap
1. Program model and budget	Bilingual staffing, self-pay policy, Hidalgo-area payer mix. Use the break-even calculator.	1–2 months
2. Site search	Zoning district, the four sign-offs, the four questions above	about 30 days
3. Lease with a contingency	Out if the certificate or license fails; free rent for the build-out	about 3 weeks
4. Build-out	Registered contractor, 2021 code, electronic plan review	about 6 weeks
5. Certificate of occupancy and fire inspection	Display the certificate; keep copies for HHSC and the accreditor	about 3 weeks
6. HHSC license and inspection	File with bilingual policies and packets ready	about 2–3 months
7. Facility contracts	TMHP, then Molina, Superior and UnitedHealthcare/Optum, and commercial plans	about 90 days each

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.

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

Questions

Which Medicaid service area is Laredo in?

The Hidalgo service area: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy and Zapata counties. A Laredo program contracts with the same Medicaid plans as programs in McAllen and Brownsville.

Which Medicaid plans should a Laredo IOP apply to first?

For adults, the plans in both STAR and STAR+PLUS: Molina, Superior and UnitedHealthcare (through Optum for behavioral health). For adolescents, add Driscoll Health Plan. Confirm the current line-up on HHSC's map and ask each plan whether its behavioral health network is open.

Does a Laredo certificate of occupancy transfer if I buy a program?

No. The city says the certificate isn't transferable, and a change in ownership, business name, type of business, use or site plan terminates it. Plan for a new certificate, and a new or amended HHSC license, when a program changes hands.

Who is the local mental health authority in Laredo?

Border Region Behavioral Health Center, which serves Webb, Zapata, Jim Hogg and Starr counties.

Do we have to offer services in Spanish?

Texas requires certain postings, including the client bill of rights and grievance procedure, in English and a second language. Beyond that rule, a Laredo program that can't counsel in Spanish will turn away much of its market, so plan bilingual staff or a written interpreter policy.

Other Texas cities: San Antonio, El Paso, Midland–Odessa, and every city guide on opening a program in Texas, by city.

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

Sources

• HHSC, Managed Care Service Areas map: hhs.texas.gov; STAR+PLUS service area by county (revision 26-2, June 2026): fhb.hhs.texas.gov
• City of Laredo Building Development Services, permit applications and requirements: cityoflaredo.com
• HHSC Crisis Services Guide (local mental health authorities and counties): hhs.texas.gov; HHSC OSAR: hhs.texas.gov
• TMHP, substance use disorder benefit changes: tmhp.com
• 49 CFR Part 40, Subpart O: ecfr.gov; FMCSA Drug and Alcohol Clearinghouse: fmcsa.dot.gov
• 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 chapter 123: statutes.capitol.texas.gov; 42 CFR Part 2: ecfr.gov