Behavioral Health Licensing in Maryland
Mental health and substance use programs in Maryland are licensed by the Behavioral Health Administration under COMAR 10.63 — and most must earn CARF accreditation before they can be licensed. Here's how the path works, and how we get you accredited and licensed.
- What it covers
- Community-based mental health & substance use programs
- Licensed by
- Maryland Dept. of Health, Behavioral Health Administration (BHA)
- Governing regulation
- COMAR 10.63
- Accreditation
- Required first — most pursue CARF (Joint Commission or COA also accepted)
- Funding
- Public Behavioral Health System / Medicaid
How behavioral health licensing works
If you're opening a mental health or substance use program in Maryland, the Behavioral Health Administration is your licensing body. Both mental health and substance use disorder programs fall under the same framework — COMAR 10.63 — which sets the licensing and accreditation standards for community-based behavioral health programs.
The big difference from RSA and DDA: behavioral health programs are accreditation-based licenses. New applicants generally need preliminary accreditation before the state will license them — and for behavioral health and substance use programs, that most often means CARF. (The Joint Commission and COA are also accepted.) This accreditation step shapes your timeline, your budget, and your policies, so it's where planning matters most.
The rules here are also evolving: Maryland moved BHA licensing to an online application system in 2025, and further regulatory updates have been in development. We track these changes so your application reflects current requirements.
Why CARF accreditation is the heart of it
CARF — the Commission on Accreditation of Rehabilitation Facilities — is the accreditation most Maryland behavioral health and substance use programs pursue. It's an independent, nonprofit accreditor whose standards Maryland recognizes for licensure, and for new programs it's effectively a prerequisite: you earn at least preliminary CARF accreditation before BHA licenses you.
That sequencing is the single most important thing to plan around. CARF isn't a form you file — it's a demonstration that the way you actually operate conforms to a detailed set of standards, confirmed through an on-site survey and awarded for a fixed term. Programs that treat it as an afterthought lose months; programs that build for it from day one move quickly.
What CARF readiness involves
- Policies and procedures mapped to CARF standards
- Documented business, clinical, and governance practices
- A performance and quality improvement framework
- Service delivery and records that match your written processes
- Health, safety, and rights-of-the-person-served protections
- Preparation for the CARF on-site survey
Where we come in: we build your COMAR 10.63 and CARF-aligned policies together and get you survey-ready, so accreditation and licensure move as one coordinated process — not two separate scrambles.
What BHA licenses
BHA licenses many program types. These are three of the most common starting points — tap to talk through your plans.
Outpatient Mental Health Center (OMHC)
Community-based outpatient mental health treatment, led by a medical director and a multidisciplinary clinical team.
Learn about OMHC → RehabilitationPsychiatric Rehabilitation Program (PRP)
Community-based rehabilitation and recovery supports for adults (PRP-A) or minors (PRP-M), under a rehabilitation specialist.
Talk to us about PRP → Substance UseSubstance Use Disorder Programs
SUD treatment across ASAM levels — outpatient, IOP, partial hospitalization, residential, withdrawal management, and OTP.
Talk to us about SUD →Other BHA-licensed programs
What a BHA license typically requires
Requirements vary by program, but most behavioral health applicants need to put together:
- CARF accreditation (Joint Commission or COA also accepted)
- Policies & procedures compliant with COMAR 10.63
- Required key staff (e.g., Medical Director or Rehabilitation Specialist)
- A licensed, accessible service site in each jurisdiction served
- Criminal background investigation policy and clearances
- An agreement to cooperate with the local behavioral health authority
- Medicaid enrollment to bill the Public Behavioral Health System
- Business formation, insurance, and a defined scope of services
From plan to licensed program
We help you build the documentation behavioral health licensing demands and navigate each stage — with CARF accreditation and licensure run as one coordinated process, so neither stalls your launch.
Free consultation
We confirm the right program type and map your path.
CARF readiness
We prepare your policies and operations for the CARF survey and COMAR 10.63.
Policies & application
Custom policies and a complete licensure application.
You get licensed
Through licensure and Medicaid enrollment, into operations.
Behavioral health licensing FAQ
For most community behavioral health programs, yes — new applicants generally need preliminary accreditation before BHA will license them, and CARF is the route most behavioral health and substance use programs take (the Joint Commission and COA are also accepted). It's the defining feature of behavioral health licensing in Maryland, and the part that most affects your timeline.
All three are accepted in Maryland, but CARF is the most widely used accreditor for behavioral health and human-services programs, and its standards map closely to how community mental health and substance use programs operate. We'll confirm the best fit for your program — but for most of our clients, CARF is the path.
They fall under the same COMAR 10.63 framework, but the specific standards differ by program type — an OMHC, a PRP, and an SUD residential program each have their own requirements and key-staff rules. We'll align your application with the exact program you're pursuing.
That depends on the services you want to provide and who you'll serve. OMHC and PRP are common starting points for mental health; SUD providers choose among ASAM levels. A free consultation is the fastest way to land on the right one.
Behavioral health timelines are driven largely by accreditation, which runs on its own cycle. Building accreditation readiness and your policies in parallel is the best way to keep things moving. We'll give you a realistic estimate for your program on your consultation.
Behavioral health services are largely delivered through Maryland's Public Behavioral Health System. Once licensed, you enroll in Medicaid — and note that separate enrollment numbers are typically required for each program type and location.
Planning a Behavioral Health Program?
Book a free consultation and we'll confirm the right program type, then map your accreditation and licensure path.
Request a free consultation
Tell us about your program and we'll be in touch.