Virginia behavioral health providers have new regulatory requirements to consider in 2026. The Department of Behavioral Health and Developmental Services, or DBHDS, has issued emergency regulations that amend the Rules and Regulations for Licensing Providers under 12VAC35 105.
The changes align Virginia’s behavioral health licensing regulations with the redesigned Medicaid behavioral health services being implemented by the Department of Medical Assistance Services, or DMAS. The emergency regulations became effective September 28, 2026, and will remain effective through March 27, 2028.
For providers, understanding these 12VAC35 105 changes is essential for effective preparation and regulatory compliance.
Why Did Virginia Change 12VAC35 105?
The regulatory changes respond to modifications in Virginia Medicaid behavioral health services.
According to DBHDS, DMAS is replacing legacy services with three updated service suites:
Community Psychiatric Support and Treatment, or CPST
Coordinated Specialty Care, or CSC
Recovery and Empowerment Centers, or REC
DBHDS used emergency regulatory authority to align its licensing requirements with these Medicaid service changes.
Therefore, providers planning to offer these services need to understand both the updated licensing framework and the operational requirements that apply to their selected service.
What 12VAC35 105 Sections Changed?
The emergency regulations make targeted amendments and additions within 12VAC35 105.
For REC services, DBHDS amended 12VAC35 105 20 and 12VAC35 105 30 and added sections 12VAC35 105 1412 through 1419.
For CPST services, DBHDS amended 12VAC35 105 20, 12VAC35 105 30, and 12VAC35 105 1420 and added sections 12VAC35 105 1421 through 1425.
For CSC services, DBHDS amended 12VAC35 105 20 and 12VAC35 105 30 and added sections 12VAC35 105 1426 through 1429.
These additions create specific regulatory provisions for the redesigned services.
Who Needs to Pay Attention to These Changes?
The changes are particularly important for providers applying to offer REC, CPST, or CSC services.
DBHDS specifically instructs providers currently applying to provide these services to review the new regulatory sections carefully. Providers must also ensure their policies, procedures, staffing, and service descriptions meet the applicable requirements.
Consequently, providers should review their current compliance materials rather than assume that existing documentation automatically satisfies the new requirements.
How Should Providers Prepare?
Preparation should begin with a structured regulatory review.
First, identify the service your organization intends to provide. Next, review the applicable sections of 12VAC35 105 and compare the requirements with your current policies and procedures.
Then, evaluate your staffing arrangements and service descriptions. Look for inconsistencies, outdated language, or missing information that could affect your readiness.
Finally, document the changes your organization needs to make and establish a timeline for completing them.
This approach can help providers address compliance gaps before they interfere with licensing or service implementation.
Do Providers Need to Monitor More Than Licensing Regulations?
Yes.
The DBHDS emergency regulations form part of a larger effort to align behavioral health licensing with Medicaid service changes. Providers should therefore monitor both DBHDS regulatory communications and applicable DMAS guidance.
DBHDS has also filed a Notice of Intended Regulatory Action, or NOIRA, to begin the standard regulatory process for making these amendments permanent. The process includes opportunities for public comment.
As the regulatory process continues, providers should remain attentive to official updates that could affect future requirements.
What Is the Effective Period?
The emergency regulations took effect on September 28, 2026. Under the DBHDS memorandum, they remain in effect through March 27, 2028.
This gives providers a defined period in which the emergency regulations apply while the standard regulatory process moves forward.
However, providers should not wait until the end of the emergency period to review their compliance. Early preparation allows organizations to identify and address issues before they become operational challenges.
Next Steps for Providers
Start by determining whether your organization plans to provide REC, CPST, or CSC services. After that, review the applicable 12VAC35 105 provisions and compare them with your current policies, procedures, staffing arrangements, and service descriptions.
Next, make the necessary updates and maintain documentation showing how your organization addressed the applicable requirements. Finally, continue monitoring DBHDS communications, the Virginia Regulatory Town Hall, and relevant DMAS guidance for future developments.
Frequently Asked Questions
- What are the 12VAC35 105 changes?
The changes amend Virginia’s behavioral health provider licensing regulations to align them with redesigned Medicaid behavioral health services, including REC, CPST, and CSC.
- When did the changes become effective?
The emergency regulations became effective September 28, 2026. They are scheduled to remain effective through March 27, 2028.
- Which providers should review the new requirements?
Providers currently applying to provide Recovery and Empowerment Centers, Community Psychiatric Support and Treatment, or Coordinated Specialty Care should carefully review the applicable requirements.
- What areas should providers review?
DBHDS specifically identifies policies, procedures, staffing, and service descriptions as areas providers should ensure meet the applicable requirements.
- Will the 12VAC35 105 changes become permanent?
DBHDS has initiated the standard regulatory process through a Notice of Intended Regulatory Action. The process provides opportunities for public comment as the Department considers making the amendments permanent.
Final Thoughts
The 12VAC35 105 changes mark an important regulatory development for Virginia behavioral health providers. Organizations preparing to provide REC, CPST, or CSC services should review the applicable requirements carefully and align their policies, procedures, staffing, and service descriptions accordingly.
By taking action early and monitoring official DBHDS and DMAS updates, providers can better prepare for the evolving behavioral health regulatory environment.
