Building an Outpatient Mental Health Clinic (OMHC) in Maryland doesn’t have to be difficult, especially if you know the steps to take to successfully build your clinic. In this blog post we are going to walk through the entire process from start to finish. At the end of the blog is a link to our free downloadable step-by-step guide. This guide outlines the key steps to successfully launch your OMHC.

1. Develop Your Business Plan + Foundation

A well-structured business plan is essential for securing funding and guiding the establishment of your clinic:

• Define Your Vision & Services: Identify the populations served, therapy types, and any specialty programs.
• Legal Structure & Licensing: Register the business, obtain an NPI number, and establish a Tax ID (EIN).
• Maryland Behavioral Health Administration (BHA) Licensing
  • Submit a Letter of Intent (LOI) to the BHA.
  • Obtain accreditation from CARF or TJC (required for OMHCs).
  • Ensure compliance with COMAR regulations for OMHCs.

2. Prepare the Facility + Prepare for Compliance

With site selection and preparations keep in mind that an OMHC facility must meet health and safety standards. The facility needs to provide a comfortable and confidential environment for clients and include administrative offices, therapy rooms, and a waiting area.

• Site Selection & Zoning Approval: Choose a compliant, accessible location.
• Facility Setup & Safety Requirements:
  • Ensure HIPAA compliance, secure records storage, and safety protocols.
  • Set up electronic health records (EHR) and billing systems.
• Policy & Procedure Development: 
  • Clinical policies, crisis management, and client intake workflows.
  • Compliance with Medicaid, insurance providers, and ethical guidelines.

3. Staffing + Credentialing

Just as important to the process as the facility is having staff to run it. Below are the personnel that an OMHC will need to operate to its full potential.

• Recruit Required Staff (following Maryland requirements)
  • Clinical Director (License Psychiatrist, PhD, LCSW-C, etc)
  • Licensed therapists (LCPC, LCSW-C, psychologists)
  • Psychiatrists/Nurse Practitioners (for medication management)
  • Administrative and billing personnel
• Credentialing and Insurance Enrollment
  • Enroll providers with Medicaid, private insurers, and Medicare (if applicable)
  • Establish contracts with Maryland’s Public Behavioral Health System (PBHS)

4. Program Development + Service Delivery

The program that your OMHC is going to offer is arguably one of the most important pieces to building your clinic.

• Design Core Services:
  • Individual and group therapy, psychiatric evaluations, medicaiton management.
  • Crisis intervention, case management, and telehealth options.
• Implement EHR & Compliance Systems
  • Ensure proper documentation, billing, and outcome tracking.
• Develop Referral & Outreach Networks
  • Partner with hospitals, schools, and social service agencies.
  • Build a referral pipeline from primary care providers.

5. Financial + Operational Setup

To open an OMHC in Maryland you will need to secure funding and develop marketing.

• Establish Billing & Revenue Cycle Management
  • Set up Medicaid/insurance billing systems.
  • Determine private pay and sliding scale fee structures.
• Secure Funding (if needed)
  • Grants, loans, or investor backing for startup costs
• Develop Marketing & Outreach Strategy
  • Digital presence, community networking, and engagement with referral sources

6. Accreditation + Final Approval

When getting your OMHC facility accredited there are some choices that will need to be made. Choosing between different accreditation processes is first. The accreditation process is how you will obtain your final license and approval.

• Complete Accreditation (CARF/TJC) & State Inspections
  • Ensure clinical documentation, compliance audits, and facility readiness.
• Obtain Final BHA License & Approval
  • Once accredited and operationally ready, apply for Maryland BHA final approval.

7. Launch + Continuous Improvement

The Launch of your facility is the final step to opening up the OMHC facility that you have worked so hard for.

• Begin Service Delivery & Client Intake
  • Implement processes and monitor client flow
• Ongoing Compliance & Quality Assurance
  • Regular audits, staff training, and feedback loops
  • Continuous program evaluation for improvement and expansion

Building an OMHC in Maryland requires persistence and careful planning, but it is a rewarding endeavor that can make a significant impact on your community’s mental health. By following these steps, you can establish a compliant, efficient, and effective clinic that provides essential mental health services to those in need.

We have a free PDF download to help you with building an OMHC! Click the link here to take you to our free guide. Mental Health Business Guide