Guides · Published November 13, 2026

Outpatient vs. residential addiction treatment in Texas: what the state license tells you

Outpatient treatment means you live at home and go to scheduled sessions. Residential treatment means you stay at the facility around the clock. In Texas, the state license for each treatment location says which of those it is allowed to provide, and you can check it. Of the 650 licensed treatment sites on the Texas Health and Human Services Commission (HHSC) list dated October 21, 2026, 546 are licensed for outpatient care, 188 for residential care, and 84 for both. That license is the first thing to check when you weigh outpatient vs. residential care.

The two settings, in plain words

SAMHSA, the federal substance use agency, defines outpatient care as treatment “without an overnight stay at a treatment facility or hospital.” That can mean an hour a week of counseling, or an intensive outpatient program (IOP) with several sessions a week.

Residential care is 24-hour care where you sleep at the program. Some residential programs are short-term and some are long-term. Hospital inpatient care is a separate setting, run inside a hospital, and it requires at least one overnight stay.

Which one is right is a clinical question. A doctor or a licensed counselor doing an assessment should recommend a level of care. This guide does not make that call. It helps you check that a place is licensed for the kind of care it is offering you.

What the Texas license covers

Texas law requires a license for chemical dependency treatment facilities, and HHSC is the agency that licenses and inspects them. HHSC’s application instructions say a facility “must have a license for each physical location where the facility provides residential or outpatient services.”

That means:

The license is tied to an address. A company with three clinics should have each location on the state list.
The license lists the services. On the HHSC list, each site row shows “Outpatient Treatment,” “Residential Treatment,” or both.
Residential sites list beds. All 188 residential sites on the list show a bed count. They range from 6 to 298 beds, with a median of about 37.

HHSC also notes that these facilities are not certified for Medicare. That’s about the facility license; a hospital or other provider may bill Medicare under a different certification.

Faith-based programs are different

Faith-based programs that offer only nonmedical help, such as prayer, spiritual counseling, and scripture study, do not need an HHSC treatment license. They register with HHSC for an exemption instead. The October 2026 faith-based list has 83 programs. On this site, those are labeled “Faith-based, registered with HHSC,” not “licensed.”

Where residential care is in Texas

Licensed treatment is not spread evenly across the state. Our count of the HHSC list:

102 of Texas’s 254 counties have at least one licensed treatment site.
Only 56 counties have a licensed residential site.
Harris County has the most licensed sites (103) and the most residential sites (26). Tarrant has 14 residential sites, and Travis has 11.

If you live in a county with no residential site, a residential program will mean travel. Our county pages show what each county has.

How to check a program’s license yourself

Get the exact name and street address of the location where you would receive care.
Look it up on HHSC’s Chemical Dependency Treatment Facilities page. Use “Verify a facility license by searching the Online Licensing System,” or open the Excel list linked there.
Check that the address matches, the license has not expired, and the service type matches what you are being offered. If you’re promised a residential stay, the license for that address should say residential.
If something doesn’t match, ask the program to explain, and contact HHSC with questions. HHSC’s page also links to its enforcement actions and to a way to file a complaint.

How to use this directory

Each licensed listing on this site shows the HHSC license number, effective and expiration dates, whether it is licensed for outpatient or residential care, beds or slots, and accreditation where the state list includes it. You can filter to licensed outpatient or licensed residential sites, or browse by county.

Where we could match a program to SAMHSA’s 2025 national directory by address or phone, the listing also shows what the program reported to SAMHSA about payment, detox, languages, and groups served. Those details are self-reported and can change. The state list is the source for license facts.

We do not take referral fees or route calls. Listings are not recommendations.

If you need help now

SAMHSA National Helpline: 1-800-662-HELP (4357). Free, confidential, 24/7 treatment referral and information.
988 Suicide & Crisis Lifeline: call or text 988.
In an emergency, call 911.

This guide is general information, not medical or legal advice. Licensing data comes from the HHSC list dated October 21, 2026; confirm a program’s current license with HHSC before you enroll.