CCBHC Designated Collaborating Organizations (DCOs): FAQs

Certified Community Behavioral Health Clinics (CCBHCs) can partner with other organizations, called designated collaborating organizations (DCOs), to provide mental health and substance abuse services. These DCOs can offer any of the services required by SAMHSA’s certification rules.

This guide answers common questions about working with DCOs. It’s current as of January 2025 and will be updated if SAMHSA or CMS release new guidelines.

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Disclaimer: This FAQ document is a product of the National Council for Mental Wellbeing. It provides information summarized from federal guidance and offers recommended practices drawn from our team’s experience with the CCBHC model, but it does not constitute official guidance from SAMHSA or CMS. States participating in the demonstration or adopting the CCBHC model under other Medicaid authority may impose requirements or expectations for DCO arrangements that build on the federal guidance. Questions about specific DCO relationship and payment arrangements should be directed to SAMHSA, CMS or state Medicaid and behavioral health agencies, as appropriate. Guidance from any of these entities supersedes any information found in this document.