Integrated Outpatient Services (IOS) Application Instructions under the 404 Regulations

Outpatient Services

New York State established the licensure category "Integrated Outpatient Services," appearing simultaneously within identical regulations for the Department of Health licensed providers (10 NYCRR Part 404), Office of Mental Health licensed providers (14 NYCRR Part 598), and Office of Alcoholism and Substance Abuse Services certified providers (14 NYCRR Part 825).

These regulations recognize the comorbidity of behavioral (i.e., mental illness and/or substance use disorders) and physical health conditions and intend to promote increased access to outpatient physical and behavioral health services at a single site. These regulations establish standards for such integrated services in certain outpatient settings

10 NYCRR Part 404 can be found here:

The implementation guidance can be found here:

Application Instructions for PHL Article 28-Licensed Outpatient Providers

Outpatient providers licensed under Article 28 of the Public Health Law who wish to integrate behavioral health services under 10 NYCRR Part 404 must complete a DOH Certificate of Need (CON) Application (either full review CON Application or an administrative review CON Application, as appropriate) or a Limited Review Application (LRA) for each Article 28-licensed site at which services will be integrated.

  • If a provider wishes to add mental health services or substance use disorder services under 10 NYCRR Part 404 at an existing clinic and the project costs do not exceed $6,000,000, the provider should submit an LRA. However, if project costs exceed $6,000,000, the appropriate CON Application must be filed rather than an LRA.
  • If a provider wishes to certify a new extension clinic and integrate services under 10 NYCRR Part 404, the provider should submit the appropriate CON Application.

All applications must be submitted via the NYSE-CON system. Applications will be reviewed by the agencies on a rolling basis and applicants will be notified by DOH when the review is completed.

CON Application:

The CON Application can be found here: CON Application.

The CON Application consists of 23 schedules. To determine which schedules must be submitted, please see the following link: Schedules Required for Each Type of Application.

Limited Review Application:

The LRA can be found here: Limited Review Application .

The LRA includes a cover sheet and 12 schedules. The applicant must submit all of the LRA schedules required as part of a "Service Delivery" project (as indicated on the LRA Cover Sheet). If the project involves construction, the applicant must also submit the LRA schedules associated with a "Minor Construction" project.

Additional Required Information:

In addition to providing information required in the schedules noted above, the following information must be included as part of the application as separately uploaded documents under schedule type "Other."

  • Integrated Outpatient Services Application - (Complete sections I, II, III, V and VII)
  • For applicants adding substance use disorder services, please attach documentation confirming the Medical Director possesses a Federal DATA 2000 waiver (buprenorphine-certified) and holds at least one of the following certifications
    • Subspecialty board certification in addiction psychiatry from the American Board of Medical Specialties; or
    • Addiction certification from the American Society of Addiction Medicine; or
    • Certification by the American Board of Addiction Medicine (ABAM); or
    • Subspecialty board certification in Addiction Medicine from the American Osteopathic Association.

    The provider may either employ a qualified medical director or have a consultation agreement with a full- or part-time physician who meets the requirements noted above. In either case, please provide appropriate documentation.