Medicaid Behavioral Health Services: ASAM Level 2.1 - Intensive Outpatient Treatment (IOT)

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 41; No - 4; NR - 6	Yes - 5	Yes - 11
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	NR
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	No
Florida	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	No
Indiana	Yes	No	Prior authorization is required
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	NR
Maine	Yes	$.50 to $2 per day, depending on payment amount, up to $20 per month	Minimum of 3 hours per day, 3 days per week
Maryland	Yes	No	NR
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	$3	Prior authorization is required
Missouri	Yes	No	No
Montana	Yes	Yes - not specified	Requires continued stay reviews
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization is required
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	Inital authorization is 60 days; reauthorization is 180 days.
North Dakota	Yes	No	No
Ohio	Yes	No	Yes - not specified
Oklahoma	Yes	$3	No
Oregon	Yes	No	No
Pennsylvania	No
Rhode Island	Yes	No	Yes - not specified
South Carolina	Yes	No	Prior authorization is required
South Dakota	Yes	No	No
Tennessee	Yes	No	No
Texas	No
Utah	NR	NR	NR
Vermont	Yes	No	NR
Virginia	Yes	No	Service authorization is required
Washington	Yes	No	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	No
Wyoming	Yes	No	No

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