Medicaid Behavioral Health Services: ASAM Level 4 - Medically Managed Intensive Inpatient Treatment

Medicaid Behavioral Health Services: ASAM Level 4 – Medically Managed Intensive Inpatient Treatment

This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 39; No - 6; NR - 6	Yes - 3	Yes - 14
Alabama	No
Alaska	Yes	No	NR
Arizona	Yes	NR	Prior authorization (for non-emergencies) and concurrent review
Arkansas	NR	NR	NR
California	Yes	No	Prior authorization required (non-quantitative treatment limitation (NQTL))
Colorado	Yes	No	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Authorization is required
Florida	No
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	Prior authorization is required
Indiana	Yes	No	Prior authorization is required
Iowa	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	No
Maine	Yes	No	No
Maryland	Yes	No	Limit of 15 days per month
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	$10 per day	Prior authorization is required
Missouri	No
Montana	Yes	No	Yes - not specified
Nebraska	Yes	NR	NR
Nevada	Yes	No	NR
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	Prior authorization is required after first 8 hours; initial prior authorization is 5 days; 45 days per state fiscal year but can be exceed for medical necessity
North Dakota	Yes	No	No
Ohio	Yes	No	Yes - not specified
Oklahoma	Yes	$10 per day, $75 maximum	NR
Oregon	Yes	No	No
Pennsylvania	Yes	$3 per day, not to exceed $21 per admission	No
Rhode Island	Yes	No	Yes - not specified
South Carolina	No
South Dakota	Yes	NR	NR
Tennessee	Yes	No	No
Texas	Yes	No	Prior authorization is required
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	Yes	No	NR
Wyoming	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 43 No - 2 NR - 6	Yes - 4	Yes - 15
Alabama	NR	NR	NR
Alaska	Yes	Depends on facility type, hospital is $50 a day up to a max of $200	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	Yes	No	Authorization required
Delaware	Yes	No	Prior Approval with specific treatment plan
District of Columbia	Yes	No	PA required for utilization above certain benchmarks
Florida	Yes	No	Florida Medicaid reimburses for up to 45 inpatient hospital days per fiscal year for recipients age 21 years or older; Florida Medicaid reimburses for inpatient hospital days beyond the 45 day limit for emergency services, as defined in Rule 59G-1.010, F.A.C.
Georgia	No
Hawaii	Yes	No	No
Idaho	Yes	No	NR
Illinois	NR	NR	NR
Indiana	Yes	No	Prior authorization required
Iowa	NR	NR	NR
Kansas	Yes	No	No
Kentucky	Yes	Co Pay $50	No
Louisiana	Yes	No	No
Maine	Yes	No	No
Maryland	Yes	No	Services are pre-authorized
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	Requires Prior Authorization
Missouri	Yes	No	No
Montana	Yes	No	Prior Authorization/Continued Stay Reviews
Nebraska	Yes	No	No
Nevada	Yes	No	Allowed under Med/Surg hospital or through MCOs up to 15 days.
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	NR	NR	NR
North Carolina	Yes	No	Authorization required after first 8 hours of admission; admission limited to 5 days
North Dakota	Yes	NR	Hospital-based only.
Ohio	Yes	No	No
Oklahoma	Yes	$10 per day for first seven days; $5 on the eighth day.	NR
Oregon	Yes	No	No
Pennsylvania	Yes	No	Medical necessity
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	Yes	No	NR
Tennessee	Yes	No	No
Texas	Yes	No	Requires prior authorization
Utah	Yes	No	No
Vermont	Yes	No	Professional services provided to residents of approved treatment centers who are in need of detoxification in approved treatment center limited to 7 days of service per acute episode
Virginia	Yes	No	No
Washington	Yes	No	No
West Virginia	Yes	No	PA Required
Wisconsin	Yes	$3 per day with a $75 cap per stay	NR
Wyoming	No

Topics

Policy Research

Polling

Health News

Data & Features

For Media

About

Medicaid Behavioral Health Services: ASAM Level 4 – Medically Managed Intensive Inpatient Treatment

Data are loading

Medicaid Behavioral Health Services: ASAM Level 4 – Medically Managed Intensive Inpatient Treatment

2022

2018

Topics

Categories