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Details

Detailed Information for : Mental Health, Outpatient Psychotherapy Clinic
Description:
Initial certification for an entity that provides a continuum of treatment services, either through direct provision of services or through written procedures that document how additional services from other service providers will be arranged, to meet the overall treatment needs of the patient.  
License Type:
Original  
Duration:
One year.  
Fees:
In combination with other Community Substance Abuse Services (CSAS) or Mental Health programs, $350 for one program, $500 for two, $600 for three, $675 for four, $750 for five or more programs at one location; $200 additional fee per branch office.  
Prerequisites:
Contact the Division of Quality Assurance at (608) 261-0658 or e-mail  
Additional Information:
Certification is required prior to an entity receiving reimbursement under Chapter 46 and/or 51, Wisconsin Statutes; 3rd party reimbursement; and/or reimbursement for participants in the Medicaid program.

See our website for more information.  
Application Form(s):
Contact the Division of Quality Assurance at (608) 261-0658 or e-mail  
Wisconsin Statutes:
Wisconsin Statute 51.45, State Alcohol, Drug Abuse, Developmental Disabilities, and Mental Health Act.  
Administrative Rules/Codes:
Wisconsin Administrative Codes
HFS 61, Subchapter V, Outpatient Psychotherapy Clinic Standards and
HFS 12, Caregiver Background Check including
Appendix A, Offenses Affecting Caregiver Eligibility.  
Other Agencies Involved:
Apply for Wisconsin Medicaid (Title 19) once you are certified as an outpatient psychotherapy clinic.  
Contact Information
Contact:
Division of Quality Assurance, Behavior Health Certification Section
Home Page:
E-mail :
Hours of Operation:
7:45 am - 4:30 pm, Monday through Friday  
Phone:
(608)261-0658  
Fax:
 
TTY/TDD:
 
Mail Address:
PO Box 2969, Madison, WI 53701-2969  
Street Address:
1 West Wilson Street, Madison, WI 53703  
Agency Web Site:
 
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For additional assistance with business-related license, permit and registration information, visit the Wisconsin Small Business Development Center at http://www.wisconsinsbdc.org or phone them at 608-263-7680.


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