Under Washington Department of Health regulations, eligible mental health professionals who obtain the enhancement may provide substance use disorder counseling services within the scope of a Substance Use Disorder Professional, subject to specific practice limitations.

For agencies, this can mean developing existing staff to provide additional SUD counseling services to clients with co-occurring mental health and substance use disorders, while potentially expanding opportunities for reimbursable treatment.

**Important considerations:** CODSE holders must work in an authorized setting, such as an agency providing counseling services, a federally qualified health center, or a hospital. SUD treatment is limited to clients diagnosed with both a mental health disorder and a substance use disorder. Additional requirements apply when clients need higher levels of care.

The enhancement does not independently guarantee insurance reimbursement. Billing eligibility depends on applicable agency certification, payer contracts, covered services, and other regulatory and reimbursement requirements.