States license treatment programs in different ways: some with one license and a component for each service, some with separate substance use and mental health licenses, some by certification. Opioid treatment programs need four approvals, and a few states add a need review before any of them. Recovery residences are licensed in some states, certified voluntarily in others, and not regulated at all in some. Every fact here links to its source; anything we could not confirm is marked as not verified rather than guessed.
Opening an opioid treatment program? The four approvals, in order.
Verified October 10, 2026. Each state decides its own applications; confirm with it before you rely on a detail.
Compare every state
| State | Program license | How it is structured | OTP need review | Recovery residences |
|---|---|---|---|---|
| Alabama | Not verified | State certification | Not verified | Not verified |
| Alaska | Not verified | State certification | Not verified | Not verified |
| Arizona | Yes | Not verified | Not verified | State license |
| Arkansas | Not verified | Not verified | Not verified | Not verified |
| California | Yes | Not verified | Not verified | Not verified |
| Colorado | Not verified | One license with service components | Not verified | State license |
| Connecticut | Yes | Not verified | Certificate of need | Not verified |
| Delaware | Yes | Not verified | Not verified | Voluntary certification |
| District of Columbia | Not verified | Not verified | No | Not verified |
| Florida | Yes | One license with service components | Not verified | Voluntary certification |
| Georgia | Not verified | Not verified | Open enrollment window | Not verified |
| Hawaii | Not verified | Not verified | Not verified | Not verified |
| Idaho | Not verified | State certification | Not verified | Not verified |
| Illinois | Yes | One license with service components | Not verified | State license |
| Indiana | Yes | State certification | Not verified | Not verified |
| Iowa | Yes | Not verified | Not verified | Not verified |
| Kansas | Yes | Not verified | Not verified | Not verified |
| Kentucky | Yes | Not verified | Not verified | Not verified |
| Louisiana | Yes | One license with service components | No | Not verified |
| Maine | Not verified | Not verified | Not verified | Not verified |
| Maryland | Yes | One license with service components | Not verified | Not verified |
| Massachusetts | Not verified | Not verified | State need review | Voluntary certification |
| Michigan | Yes | Not verified | Not verified | Not verified |
| Minnesota | Yes | Separate SUD and mental health licenses | Not verified | Not verified |
| Mississippi | Not verified | State certification | State need review | Not verified |
| Missouri | Not verified | State certification | Not verified | Not verified |
| Montana | Yes | Separate SUD and mental health licenses | Not verified | Not verified |
| Nebraska | Not verified | Not verified | Not verified | Not verified |
| Nevada | Not verified | State certification | Not verified | Not verified |
| New Hampshire | Not verified | Not verified | Not verified | Voluntary certification |
| New Jersey | Yes | One license with service components | Not verified | Not verified |
| New Mexico | Not verified | Not verified | Not verified | Not verified |
| New York | Yes | Separate SUD and mental health licenses | State need review | Voluntary certification |
| North Carolina | Yes | One license with service components | No | Not verified |
| North Dakota | Yes | One license with service components | State need review | Not verified |
| Ohio | Not verified | State certification | Not verified | Registration |
| Oklahoma | Not verified | State certification | Not verified | Not verified |
| Oregon | Not verified | State certification | Not verified | Not verified |
| Pennsylvania | Yes | One license with service components | Not verified | State license |
| Rhode Island | Yes | Not verified | Not verified | Not verified |
| South Carolina | Yes | Not verified | No | Not verified |
| South Dakota | Not verified | State certification | Not verified | Not verified |
| Tennessee | Not verified | Not verified | Certificate of need | Not verified |
| Texas | Yes | Not verified | Not verified | Not verified |
| Utah | Not verified | Not verified | Not verified | State license |
| Vermont | Not verified | Not verified | Not verified | Not verified |
| Virginia | Yes | One license with service components | Not verified | State license |
| Washington | Yes | One license with service components | State need review | Voluntary certification |
| West Virginia | Yes | Not verified | State moratorium | Voluntary certification |
| Wisconsin | Not verified | State certification | Not verified | Registration |
| Wyoming | Not verified | State certification | Not verified | Not verified |
Want us to prepare it?
An outpatient program license, IOP or PHP included, is $1,995 per site; residential or withdrawal management is $2,995 per site. State and inspection fees are paid by you directly, and every fee we charge is flat. See every price.