State license and application fees
Each state sets its own license fees, so the figures below are examples from four states, not national prices. This guide lists no fee for any state it has not researched.
Arizona
Arizona's Department of Health Services lists these fees on its licensing pages and fee forms.[2]
Application fee for any health care institution license: $50, nonrefundable.
Source: azdhs.gov/includes/content/licensing/bbhl-facilities.php · Checked Nov 12, 2026
Behavioral health residential facility license fee, no licensed capacity: $495.
Source: azdhs.gov/documents/licensing/bbhl-facilities/remittance-form.pdf · Checked Nov 12, 2026
Behavioral health residential facility license fee, 1 to 59 beds: $495 plus $132 per bed.
Source: azdhs.gov/documents/licensing/bbhl-facilities/remittance-form.pdf · Checked Nov 12, 2026
License fee for the fee group that includes an outpatient treatment center, no licensed capacity: $482.
Source: azdhs.gov/documents/licensing/medical-facilities/forms/medical-facilities-remittance-form.pdf · Checked Nov 12, 2026
Sober living home license fee: $500 plus $100 per bed.
Source: azdhs.gov/documents/licensing/bbhl-facilities/remittance-form.pdf · Checked Nov 12, 2026
California
California's Department of Health Care Services lists these fees for fiscal year 2026-27, which began July 1, 2026.[4]
Initial residential licensure application fee: $6,061 (fiscal year 2026-27).
Source: dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf · Checked Nov 12, 2026
Initial biennial residential licensure fee: $644 per bed (fiscal year 2026-27).
Source: dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf · Checked Nov 12, 2026
Initial outpatient certification application fee: $5,824 (fiscal year 2026-27).
Source: dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf · Checked Nov 12, 2026
Initial biennial outpatient certification fee: $7,549 (fiscal year 2026-27).
Source: dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf · Checked Nov 12, 2026
Initial combined residential licensure and certification application fee: $8,085 (fiscal year 2026-27).
Source: dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf · Checked Nov 12, 2026
Florida
Florida's Department of Children and Families charges a fee for each licensed service component, at one rate for publicly funded providers and another for privately funded ones. The full table is in Rule 65D-30.0035.[5]
Residential Treatment I license fee, publicly funded provider: $300. Residential Treatment II, III and IV carry the same fee (Rule 65D-30.0035).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Residential Treatment I license fee, privately funded provider: $350. Residential Treatment II, III and IV carry the same fee (Rule 65D-30.0035).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Outpatient Treatment license fee, publicly funded provider: $250 (Rule 65D-30.0035).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Outpatient Treatment license fee, privately funded provider: $300 (Rule 65D-30.0035).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Texas
No public figure. We could not confirm the Texas chemical dependency treatment facility license fee on an official source, so this guide lists none.
Federal registrations and enrollment
A few federal fees apply to many programs, depending on whether you prescribe controlled substances, bill Medicare or run lab tests on site.
DEA registration for dispensing or instructing, which covers practitioner and hospital or clinic registrations: $888 for a three-year registration (21 CFR 1301.13, current text).
Source: ecfr.gov/current/title-21/chapter-II/part-1301/section-1301.13 · Checked Nov 12, 2026
DEA registration for a narcotic treatment program: $296 for a one-year registration (21 CFR 1301.13, current text).
Source: ecfr.gov/current/title-21/chapter-II/part-1301/section-1301.13 · Checked Nov 12, 2026
Medicare enrollment application fee for institutional providers: CY 2026 application fee of $750, adjusted annually, for applications submitted in calendar year 2026 (Federal Register, December 3, 2025).
Source: govinfo.gov/content/pkg/FR-2025-12-03/html/2025-21877.htm · Checked Nov 12, 2026
National Provider Identifier (NPI): free of charge (CMS notice to prescribers, undated).
Source: cms.gov/regulations-and-guidance/administrative-simplification/nationalprovidentstand/downloads/npi-requirements-for-prescribers.pdf · Checked Nov 12, 2026
CLIA Certificate of Waiver, for labs that run only waived tests: $248 biennial certificate fee (CMS fee schedule, updated 2024).
Source: cms.gov/files/document/clia-certificate-fee-schedule-updated-06/7/2024.pdf · Checked Nov 12, 2026
How often a waived-only lab pays CLIA certificate fees: every 2 years (CMS fact sheet MLN006270, March 2026).
Source: cms.gov/files/document/mln006270-clia-program-medicare-lab-services.pdf · Checked Nov 12, 2026
Opioid treatment program certification
No public figure. We found no published fee for federal opioid treatment program certification, so this guide lists none.
Accreditation and certification
The figures here come from each body's own published fee schedule. Where a body publishes no dollar figure, or no current one we could confirm, this guide says so.
CARF accreditation
CARF publishes no dollar fee for accreditation. Its accreditation steps page says "The survey fee is based on the number of surveyors and days needed to complete the survey" and asks organizations to contact CARF for an estimate.[11]
CARF ASAM Level of Care certification
CARF does publish fees for a different product, its ASAM Level of Care certification. That certification is not CARF accreditation, and its fee is not an accreditation fee.
CARF ASAM Level of Care certification base fee, standard: $4,540 (surveys starting July 1, 2026 to June 30, 2027). Not an accreditation fee.
Source: carf.org/wp-content/uploads/2026/03/Fees-JUL2026-JUN2027-LOC.pdf · Checked Nov 12, 2026
CARF ASAM Level of Care certification base fee for a CARF-accredited facility: $3,520 (same period). Not an accreditation fee.
Source: carf.org/wp-content/uploads/2026/03/Fees-JUL2026-JUN2027-LOC.pdf · Checked Nov 12, 2026
The Joint Commission
No current public figure. We could not confirm a current Joint Commission fee for behavioral health accreditation, so this guide lists none.
LegitScript certification
LegitScript lists these fees for addiction treatment certification on its own site.
LegitScript addiction treatment certification application fee, 1 to 9 facilities: $1,595 per facility, nonrefundable (page as of November 12, 2026).
Source: legitscript.com/certification/addiction-treatment-certification · Checked Nov 12, 2026
LegitScript annual certification fee, 1 to 9 facilities: $3,095 per facility (page as of November 12, 2026).
Source: legitscript.com/certification/addiction-treatment-certification · Checked Nov 12, 2026
What federal wage data shows for staff
The Bureau of Labor Statistics publishes national median annual wages for roles found in treatment programs. These are national medians from May 2025, not local salaries, and they exclude benefits and payroll taxes.
Substance abuse, behavioral disorder and mental health counselors: $59,350 median annual wage, May 2025.
Source: bls.gov/ooh/community-and-social-service/substance-abuse-behavioral-disorder-and-mental-health-counselors.htm · Checked Nov 12, 2026
Psychiatric technicians: $45,130 median annual wage, May 2025.
Source: bls.gov/ooh/healthcare/psychiatric-technicians-and-aides.htm · Checked Nov 12, 2026
Registered nurses: $97,550 median annual wage, May 2025.
Source: bls.gov/ooh/healthcare/registered-nurses.htm · Checked Nov 12, 2026
Medical and health services managers: $123,860 median annual wage, May 2025.
Source: bls.gov/ooh/management/medical-and-health-services-managers.htm · Checked Nov 12, 2026
Psychiatrists: $281,870 median annual wage, May 2025.
Source: bls.gov/ooh/healthcare/physicians-and-surgeons.htm · Checked Nov 12, 2026
Clinical and counseling psychologists: $100,580 median annual wage, May 2025.
Source: bls.gov/ooh/life-physical-and-social-science/psychologists.htm · Checked Nov 12, 2026
Licensed practical and licensed vocational nurses: $64,400 median annual wage, May 2025.
Source: bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm · Checked Nov 12, 2026
Mental health and substance abuse social workers: $60,280 median annual wage, May 2025.
Source: bls.gov/ooh/community-and-social-service/social-workers.htm · Checked Nov 12, 2026
What this data leaves out
This guide gives no staffing model, headcount or payroll total, because those depend on your state's rules and your program.
The building
We found no public figure for the rent, purchase price, renovation or construction of a treatment facility, so this guide lists none. Two related figures are published.
Registering a business with a state: "In most cases, the total cost to register your business will be less than $300, but fees vary depending on your state and business structure" (US Small Business Administration).
Source: sba.gov/business-guide/launch-your-business/register-your-business · Checked Nov 12, 2026
Florida: a substance abuse license applicant must show professional liability coverage of at least $250,000 per claim and $750,000 in annual aggregate (Rule 65D-30.0036). This is required coverage, not a premium.
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Insurance premiums
No public figure. Florida's rule sets how much coverage you need, but we found no public figure for what that coverage costs.
How long the approvals take
These are the published time frames we could find. Each belongs to one state or one body, and none is a promise of how long your application will take.
CARF accreditation
Preparation before a CARF accreditation survey: "a year or more," in CARF's words.
Source: carf.org/accreditation/steps-accreditation · Checked Nov 12, 2026
Survey window: you choose a two-month timeframe on the CARF survey application.
Source: carf.org/accreditation/steps-accreditation · Checked Nov 12, 2026
CARF accreditation decision: about six to eight weeks after the survey.
Source: carf.org/accreditation/steps-accreditation · Checked Nov 12, 2026
Quality improvement plan: due within 90 days of being notified of the CARF accreditation decision.
Source: carf.org/accreditation/steps-accreditation · Checked Nov 12, 2026
Opioid treatment program certification
Provisional certification for a new opioid treatment program that has applied for accreditation: up to 1 year (42 CFR 8.11(d)).
Source: ecfr.gov/current/title-42/section-8.11 · Checked Nov 12, 2026
Term of opioid treatment program certification: not more than 3 years (42 CFR 8.11(a)(3)).
Source: ecfr.gov/current/title-42/section-8.11 · Checked Nov 12, 2026
Medicare enrollment for certified providers
CMS publishes these step times for certified institutional providers, such as hospitals and non-deemed community mental health centers. They do not cover every treatment program.[25]
Step 1, the Medicare contractor's first review: about 30 days for a web application.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
Step 1, the Medicare contractor's first review: about 65 days for a paper application.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
Step 2, state survey agency processing, including survey requirements: about 45 days once it has a complete packet, and it may vary by state agency.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
Step 3, the contractor's review after the state agency: about 10 days without a site visit, or about 45 days with one.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
Step 4, CMS provider enrollment review and assignment of the certification number: about 30 days.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
Step 5, the contractor's final approval notice: about 3 to 10 days.
Source: cms.gov/files/document/provider-enrollment-certification-roadmap.pdf · Checked Nov 12, 2026
State time frames
Arizona: apply at least 60 and no more than 120 days before the planned opening date (A.R.S. 36-422(C)).
Source: azleg.gov/ars/36/00422.htm · Checked Nov 12, 2026
Arizona: the Department of Health Services approves or denies a complete initial application within 90 days (A.R.S. 36-425(L)(1)).
Source: azleg.gov/ars/36/00425.htm · Checked Nov 12, 2026
Arizona: an outpatient treatment center's temporary license is issued within 7 days of the department receiving the required items, and not before the planned opening date (A.R.S. 36-422(L)).
Source: azleg.gov/ars/36/00422.htm · Checked Nov 12, 2026
Arizona: a sober living home license lasts one year (A.R.S. 36-2062(B)).
Source: azleg.gov/ars/36/02062.htm · Checked Nov 12, 2026
Florida: the Department of Children and Families tells an applicant within 30 business days whether the application is complete (Rule 65D-30.0037).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Florida: the department gives a new applicant written notice that the license is granted or denied within 90 days of receiving the completed application (Rule 65D-30.0037).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Florida: a regular license status is valid for 12 months from the date of issue (Rule 65D-30.0033).
Source: flrules.org/gateway/readFile.asp · Checked Nov 12, 2026
Florida: a probationary license expires 90 days after it is issued and may not be reissued (Section 397.407(7)(a), Florida Statutes).
Source: leg.state.fl.us/statutes/index.cfm · Checked Nov 12, 2026
Texas: a chemical dependency treatment facility license expires two years after it is issued (Health and Safety Code 464.004(d)).
Source: tcss.legis.texas.gov/resources/HS/pdf/HS.464.pdf · Checked Nov 12, 2026
Texas: the Health and Human Services Commission keeps a chemical dependency treatment facility application for six months after it receives it (HHSC page, citing 26 TAC 564.403(f)).
Source: hhs.texas.gov/providers/health-care-facilities-regulation/chemical-dependency-treatment-facilities · Checked Nov 12, 2026
California: an initial residential license approved on or after January 1, 2019 runs two years and is provisional for the first year (DHCS FAQ, 2019).
Source: dhcs.ca.gov/wp-content/uploads/2025/10/AB_3162_SB_992_FAQ_2.19-1.pdf · Checked Nov 12, 2026
California: the department issues an amended license adding incidental medical services no later than 120 working days after a supplemental application is complete (DHCS notice, 2018).
Source: dhcs.ca.gov/wp-content/uploads/2025/10/MHSUDS_Information_Notice_18-031_Incidental_Medical_Services20FINAL207.20.18.pdf · Checked Nov 12, 2026
Costs that nobody publishes
We found no public figure for any of these costs, so this guide lists none of them:
- Total start-up cost of a rehab center
- Cost per bed
- Commercial rent or property cost
- Construction or renovation of a treatment facility
- Liability and malpractice insurance premiums
- Electronic health record software
- Furniture and equipment
- Marketing
- Working capital reserve
- Consultant fees
How owners get these numbers
A feasibility study or pro forma is how an owner gets these numbers for a real project. It prices your building, your market and your staffing plan with local quotes.
How to use these figures
Treat each figure as one input to a budget, not an estimate of the whole. A budget for a real project needs local quotes for the building, insurance and staff, and a fresh check of every fee with its source.
This guide is general information, not legal, billing or financial advice. Confirm current requirements with the agency and your counsel.
Sources
- [1]Residential behavioral health facility licensing · Arizona Department of Health Services · azdhs.gov/includes/content/licensing/bbhl-facilities.php
Last checked Nov 12, 2026 - [2]Behavioral health licensing remittance form · Arizona Department of Health Services · azdhs.gov/documents/licensing/bbhl-facilities/remittance-form.pdf
Last checked Nov 12, 2026 - [3]Medical facilities licensing remittance form · Arizona Department of Health Services · azdhs.gov/documents/licensing/medical-facilities/forms/medical-facilities-remittance-form.pdf
Last checked Nov 12, 2026 - [4]Behavioral Health Information Notice 26-004, licensing and certification fees · California Department of Health Care Services · dhcs.ca.gov/wp-content/uploads/2026/05/BHIN-26-004.pdf
Last checked Nov 12, 2026 - [5]Rule 65D-30.0035, licensure fees · Florida Administrative Code (flrules.org) · flrules.org/gateway/readFile.asp
Last checked Nov 12, 2026 - [6]21 CFR 1301.13, DEA registration fees and periods · Electronic Code of Federal Regulations (eCFR) · ecfr.gov/current/title-21/chapter-II/part-1301/section-1301.13
Last checked Nov 12, 2026 - [7]Provider enrollment application fee amount for calendar year 2026 (90 FR 55738) · Federal Register · govinfo.gov/content/pkg/FR-2025-12-03/html/2025-21877.htm
Last checked Nov 12, 2026 - [8]NPI requirements for prescribers (undated notice) · Centers for Medicare & Medicaid Services · cms.gov/regulations-and-guidance/administrative-simplification/nationalprovidentstand/downloads/npi-requirements-for-prescribers.pdf
Last checked Nov 12, 2026 - [9]CLIA certificate fee schedule (updated 2024) · Centers for Medicare & Medicaid Services · cms.gov/files/document/clia-certificate-fee-schedule-updated-06/7/2024.pdf
Last checked Nov 12, 2026 - [10]CLIA program and Medicare laboratory services (MLN006270, March 2026) · Centers for Medicare & Medicaid Services · cms.gov/files/document/mln006270-clia-program-medicare-lab-services.pdf
Last checked Nov 12, 2026 - [11]Steps to accreditation · CARF International · carf.org/accreditation/steps-accreditation
Last checked Nov 12, 2026 - [12]ASAM Level of Care certification fees, July 2026 to June 2027 · CARF International · carf.org/wp-content/uploads/2026/03/Fees-JUL2026-JUN2027-LOC.pdf
Last checked Nov 12, 2026 - [13]Addiction treatment certification · LegitScript · legitscript.com/certification/addiction-treatment-certification
Last checked Nov 12, 2026 - [14]Substance abuse, behavioral disorder, and mental health counselors · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/community-and-social-service/substance-abuse-behavioral-disorder-and-mental-health-counselors.htm
Last checked Nov 12, 2026 - [15]Psychiatric technicians and aides · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/healthcare/psychiatric-technicians-and-aides.htm
Last checked Nov 12, 2026 - [16]Registered nurses · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/healthcare/registered-nurses.htm
Last checked Nov 12, 2026 - [17]Medical and health services managers · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/management/medical-and-health-services-managers.htm
Last checked Nov 12, 2026 - [18]Physicians and surgeons · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/healthcare/physicians-and-surgeons.htm
Last checked Nov 12, 2026 - [19]Psychologists · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/life-physical-and-social-science/psychologists.htm
Last checked Nov 12, 2026 - [20]Licensed practical and licensed vocational nurses · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm
Last checked Nov 12, 2026 - [21]Social workers · US Bureau of Labor Statistics, Occupational Outlook Handbook · bls.gov/ooh/community-and-social-service/social-workers.htm
Last checked Nov 12, 2026 - [22]Register your business · US Small Business Administration · sba.gov/business-guide/launch-your-business/register-your-business
Last checked Nov 12, 2026 - [23]Rule 65D-30.0036, licensure application requirements · Florida Administrative Code (flrules.org) · flrules.org/gateway/readFile.asp
Last checked Nov 12, 2026 - [24]42 CFR 8.11, opioid treatment program certification · Electronic Code of Federal Regulations (eCFR) · ecfr.gov/current/title-42/section-8.11
Last checked Nov 12, 2026 - [25]Enrollment and certification roadmap for institutional providers · Centers for Medicare & Medicaid Services · cms.gov/files/document/provider-enrollment-certification-roadmap.pdf
Last checked Nov 12, 2026 - [26]A.R.S. 36-422, applying for a health care institution license · Arizona State Legislature · azleg.gov/ars/36/00422.htm
Last checked Nov 12, 2026 - [27]A.R.S. 36-425, inspections and licensure decisions · Arizona State Legislature · azleg.gov/ars/36/00425.htm
Last checked Nov 12, 2026 - [28]A.R.S. 36-2062, sober living home licensure · Arizona State Legislature · azleg.gov/ars/36/02062.htm
Last checked Nov 12, 2026 - [29]Rule 65D-30.0037, licensure application processing · Florida Administrative Code (flrules.org) · flrules.org/gateway/readFile.asp
Last checked Nov 12, 2026 - [30]Rule 65D-30.0033, license types and status · Florida Administrative Code (flrules.org) · flrules.org/gateway/readFile.asp
Last checked Nov 12, 2026 - [31]Section 397.407, Florida Statutes, licensure process and fees · Florida Legislature (Online Sunshine) · leg.state.fl.us/statutes/index.cfm
Last checked Nov 12, 2026 - [32]Texas Health and Safety Code chapter 464 · Texas Legislature · tcss.legis.texas.gov/resources/HS/pdf/HS.464.pdf
Last checked Nov 12, 2026 - [33]Chemical dependency treatment facilities · Texas Health and Human Services Commission · hhs.texas.gov/providers/health-care-facilities-regulation/chemical-dependency-treatment-facilities
Last checked Nov 12, 2026 - [34]AB 3162 and SB 992 frequently asked questions (2019) · California Department of Health Care Services · dhcs.ca.gov/wp-content/uploads/2025/10/AB_3162_SB_992_FAQ_2.19-1.pdf
Last checked Nov 12, 2026 - [35]MHSUDS Information Notice 18-031, incidental medical services (2018) · California Department of Health Care Services · dhcs.ca.gov/wp-content/uploads/2025/10/MHSUDS_Information_Notice_18-031_Incidental_Medical_Services20FINAL207.20.18.pdf
Last checked Nov 12, 2026
