Last updated: November 2026. Facts checked against OMH pages opened 2026-11-05.
A New York OMH-licensed clinic is a Mental Health Outpatient Treatment and Rehabilitative Service program, called an MHOTRS program, that runs under 14 NYCRR Part 599 and an operating certificate from the New York State Office of Mental Health (OMH). This page is for owners and administrators opening or expanding a clinic. Integral Healthcare Solutions (IHS) drafts the application materials, the policy set and a mock recertification review, your clinicians approve them, and your organization files.
What is OMH clinic licensure under Part 599?
A provider intending to operate an MHOTRS program must obtain an initial operating certificate under Part 551, and renewals run for terms of up to three years (section 599.5(a), posted Part 599 regulation, page opened 2026-11-05). Mental Hygiene Law section 31.02 prohibits operating outpatient programs providing services for persons with mental illness unless an operating certificate has been obtained from the Commissioner (section 599.2(b)). Each site needs its own certificate, which states the program type, location, hours, population, term and any approved optional services (section 599.5(b)).
The posted regulation is labeled As Adopted, and its PDF properties show March 2023; we could not reach the Department of State compilation, so we did not confirm it reflects later amendments. The MHOTRS Guidance (updated May 2025, page opened 2026-11-05) says it should not be relied on as a substitute for the final and enforceable Part 599. The OMH regulations page (page opened 2026-11-05) lists a proposed Part 599 amendment published April 1, 2026 and a proposed Part 551 repeal and replacement published September 16, 2026.
Which services must a clinic offer, and which need OMH approval?
The guidance says section 599.8 establishes eight services that must be available and offered as needed at any primary MHOTRS program licensed by OMH.
| Category | Services named in the guidance | Approval |
|---|---|---|
| Required | Assessment including health screening; psychiatric assessment; crisis intervention; psychotropic medication treatment; injectable administration, with and without monitoring and education, for programs serving adults; psychotherapy; complex care management | Available at every primary site |
| Optional | Peer support; health monitoring; health physical; psychiatric consultation; injectable administration for programs serving only children | May be implemented without OMH approval |
| Optional | Developmental testing; psychological testing; neurobehavioral status examination; intensive outpatient program | Administrative Action in the Mental Health Provider Data Exchange; if OMH supports it, OMH issues a revised certificate |
The posted regulation counts differently (section 599.8(b), page opened 2026-11-05): seven numbered services, including Treatment Planning, with injectable administration inside psychotropic medication treatment for adults only. The guidance counts eight and has no Treatment Planning entry. In our reading as of November 2026, IHS drafts to address both lists, and OMH decides which count controls.
A satellite must be approved and certified under Part 551 before it operates and needs an explicit clinical and administrative linkage with the primary program that includes, but is not limited to, staff supervision, treatment planning, review of treatment plans, records and utilization review (section 599.5(e)).
Who needs it and what triggers it?
Establishing a new program or changing the operating certificate requires prior approval under Part 551 (section 599.5(f)). Common triggers:
- Opening a new clinic. It cannot begin operation until final approval and an operating certificate are issued.
- Adding a satellite, intensive outpatient program services or testing services, each needing OMH approval.
- Hospital outpatient departments and non-hospital DOH-licensed diagnostic and treatment centers fall under Part 599 above 10,000 mental health visits annually or when mental health visits exceed 30 percent of total annual visits, except that a diagnostic and treatment center with fewer than 2,000 total visits annually is not considered one for Part 599 (guidance).
Programs providing medical services, other than health monitoring and health screening, that comprise more than five percent of total annual visits must also be licensed by the Department of Health (section 599.3(d)); the April 2026 proposal would change five percent to 30 percent. An applicant licensed by the Department of Health, or proposing services that require its approval, must determine whether a Certificate of Need application is also required, and PAR approval may be contingent upon CON approval (Becoming a Licensed Provider guidance, January 2025, page opened 2026-11-05).
How does OMH approve a new clinic?
A new clinic applies through OMH's Prior Approval Review (PAR), and final approval, from receipt to completion, may take up to several months. The sequence below comes from the PAR page, the PAR FAQ and the Becoming a Licensed Provider guidance (pages opened 2026-11-05).
- Consult first. Before submitting, you must consult your local Director of Community Services and your OMH Field Office, which identifies the application type and documentation needed. The PAR FAQ adds that a Letter of Intent must go to the Local Governmental Unit and the Field Office before a Comprehensive PAR application is submitted, except for projects deemed an emergency.
- Show the need with concrete data, then submit through the Mental Health Provider Data Exchange. Without a four-digit numeric facility code, first complete the New Provider Access Request Form.
- Answer the review. The PAR Manager sends the completed application to the Local Governmental Unit and OMH staff and issues a formal inquiry.
- Once reviewers recommend conditional approval, the project goes to the advisory council's Project Review Committee, which meets four to five times per year. The Commissioner or a designee issues Approval with Conditions, Approval or Disapproval based on the recommendation of the Local Governmental Unit, OMH and that committee.
- Clear conditions. Before OMH can issue an operating certificate, the agency must complete a site visit with the Field Office and provide a valid Certificate of Occupancy.
- Plan the first year. The initial certificate is issued for twelve months; the Field Office sends a renewal application before it expires, and you return it within 30 days.
The PAR FAQ says OMH decides a Comprehensive PAR within 90 business days of distributing a complete application for review. OMH has proposed to repeal and replace Part 551 (proposed text, page opened 2026-11-05), which could change this process.
How IHS helps
IHS prepares the documents and the rehearsal; your organization makes every decision and filing. Thomas G. Goddard, JD, PhD, founder of IHS and former URAC Chief Operating Officer and General Counsel, leads each engagement.
What IHS drafts
- A readiness review against Part 599 and the OMH guidance.
- Application narrative and attachments for your leadership to approve.
- A policy set built around the required services, with clinical content drafted for your clinicians to approve.
- A mock initial recertification review with findings and drafted corrections.
What you supply
You supply ownership and board information, the administrator and clinical lead, staffing and credentials, financial statements, control of the premises and clinical sign-off on every clinical policy.
The real limit
IHS does not decide whether OMH will license your clinic. Your organization holds the prior consultation, files the application and handles every contact with OMH, the Director of Community Services and the Field Office.
What to have ready
G is the MHOTRS Guidance, B the Becoming a Licensed Provider guidance and R the posted regulation.
- A record of your prior consultation (counties, Field Office, individuals present, date), need data, and memoranda of understanding or linkage agreements with other providers (B).
- A service plan covering every required service at the primary site and each optional service you select, with matching staffing and budget (G and B).
- A staffing plan with full-time equivalents, hours, salary cost, credentials, supervision and an organizational chart (B).
- An operating budget for the first two years with revenue by payor, and three years of financial statements prepared by a certified public accountant. OMH guidance says administrative expenses should not exceed 15% of total expenses, excluding rent or mortgage and equipment expenses (B).
- Board information. The board should include member(s) with experience operating or overseeing an Article 31 licensed program; incorporation documents must carry OMH's operating language (B).
- Site documents: address, lease or ownership, a labeled floor plan with room dimensions and a valid Certificate of Occupancy (B).
Draft policies and procedures should be submitted separately to the Field Office when the PAR application is submitted, and a finalized manual is reviewed at the initial recertification visit within the first 12 months of operation (B). Section 599.6(c)(7) says the policies include, but are not limited to, a listed set (R); the guidance calls its own list a summary that is not comprehensive (G).
On utilization review, the regulation calls for review of the need for continued treatment within seven months after admission and every six months thereafter, unless the individual is discharged and readmitted (the cycle begins again) or receives psychotropic medication treatment and medication education services only (review every 12 months thereafter) (R, section 599.6(m)). The guidance sets a minimum of 10% of all cases, reviewed randomly and independently of the treating clinical staff (G); the April 2026 proposal would add a 10% minimum of active cases to the regulation. In our reading as of November 2026, IHS drafts to meet both.
To have us compare your documents with this list, schedule the free introductory call below.
How does it compare with other paths?
This page covers a program licensed by OMH alone. The guidance says Part 599 also applies to MHOTRS programs licensed jointly by OMH, the Office of Addiction Supports and Services and the Department of Health, and the Department of Health licensing trigger described above can also apply. Accreditation is a separate program from a state operating certificate; IHS covers it on its CARF behavioral health and ACHC behavioral health pages.
What does licensure cost?
The OMH pages we reviewed state no fee amount, though the proposed Part 551 text says the Commissioner may charge a review fee under a schedule on OMH's website. Verify current fees with OMH.
IHS scopes each engagement after a free introductory call.
What this is not
- It is not legal advice. IHS is a consulting firm, not a law firm.
- It is not a guarantee that OMH will license your clinic. OMH decides.
- It is not filing or liaison work. IHS does not submit to OMH or contact it for you.
Frequently asked questions
What is a Part 599 MHOTRS program?
MHOTRS stands for Mental Health Outpatient Treatment and Rehabilitative Service. Part 599 of Title 14 of the New York Codes, Rules and Regulations sets standards for these Article 31 clinics, which need an OMH operating certificate.
Which services must a clinic offer?
OMH's guidance says section 599.8 establishes eight services that must be available and offered as needed at any primary MHOTRS program licensed by OMH. The posted regulation lists seven, including Treatment Planning.
Can optional services be added without OMH approval?
Some can. The guidance says licensed programs may implement peer support, health monitoring, health physicals and psychiatric consultation without OMH approval. Intensive outpatient and testing services need approval first.
Do satellite sites need every required service?
No. The guidance says required services must be available at all primary MHOTRS sites but not at each satellite site; a person who would benefit from one must be offered it at the primary site.
How do I get an operating certificate?
Apply through OMH's Prior Approval Review, after consulting your local Director of Community Services and your OMH Field Office. The program cannot begin operation until final approval and an operating certificate are issued.
How long does licensure take?
OMH's Becoming a Licensed Provider guidance says the timeline varies with program type, the applicant's experience and application complexity, and final approval may take up to several months.
What does it cost?
The OMH pages we reviewed state no fee amount, so verify current fees with OMH. IHS scopes each engagement after a free introductory call.
How is licensure different from accreditation and Medicaid enrollment?
An OMH operating certificate is a state license; accreditation is a separate program. Medicaid enrollment is a separate process: OMH's Becoming a Licensed Provider guidance says providers need an operating certificate number to complete the MMIS process.