Medicaid Behavioral Health Services: ASAM Level 3.1 Clinically Managed Low-Intensity Residential Services
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2022
| Location | Service Covered? | Copayment Required? | Limits on Services? |
|---|---|---|---|
| United States | Yes - 33; No - 12; NR - 6 | Yes - 1 | Yes - 14 |
| Alabama | Yes | Yes - not specified | No |
| Alaska | Yes | No | NR |
| Arizona | Yes | NR | Prior authorization 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 | No | ||
| Illinois | No | ||
| Indiana | Yes | No | Prior authorization is required |
| Iowa | No | ||
| Kansas | No | ||
| Kentucky | Yes | No | NR |
| Louisiana | Yes | No | NR |
| Maine | Yes | No | Limit of 180 days annually with no limits on number of admissions; limit may be exceeded with documented need |
| Maryland | Yes | No | Global average length of stay must not exceed 30 days |
| Massachusetts | Yes | No | No |
| Michigan | Yes | No | No |
| Minnesota | NR | NR | NR |
| Mississippi | No | ||
| Missouri | Yes | No | No |
| Montana | Yes | No | Requires prior authorization and continued stay reviews |
| Nebraska | Yes | No | No |
| Nevada | No | ||
| New Hampshire | NR | NR | NR |
| New Jersey | No | ||
| New Mexico | Yes | No | Prior authorization is required 5 days from admission and prior to moving to a different level of care |
| New York | Yes | No | No |
| North Carolina | No | ||
| North Dakota | Yes | No | No |
| Ohio | Yes | No | Prior authorization is required after utilization thresholds |
| Oklahoma | Yes | No | NR |
| Oregon | Yes | No | No |
| Pennsylvania | No | ||
| Rhode Island | Yes | No | Yes - not specified |
| South Carolina | No | ||
| South Dakota | Yes | No | No |
| Tennessee | Yes | No | No |
| Texas | Yes | No | Limit of up to 35 days per episode of care with a maximum of 2 episodes of care per rolling 6 month period and 4 episodes of care per rolling year; 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 | Subject to prior authorization |
| Wyoming | No |