Medicaid Behavioral Health Services: ASAM Level 3.7: Medically Monitored Intensive Inpatient Services

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 38; No - 7; NR - 6	Yes - 1	Yes - 15
Alabama	Yes	Yes - not specified	No
Alaska	No
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	Limited to 5 days without authorization
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	NR
Kansas	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	NR
Maine	Yes	No	Limited to 7 days for each admission episode, with no limit on the number of admissions or covered days on an annual basis
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	Yes	No	NR
New Hampshire	NR	NR	NR
New Jersey	Yes	No	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	Yes	No	Initial authorization is 10 days; reauthorization is 10 days; limit of 45 days per state fiscal year but can be exceeded for medical necessity
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	Yes	No	Prior authorization is required
South Dakota	Yes	No	No
Tennessee	Yes	No	No
Texas	Yes	No	Limit of up to 21 days per episode of care; 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	No
Wyoming	No

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Medicaid Behavioral Health Services: ASAM Level 3.7: Medically Monitored Intensive Inpatient Services

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Medicaid Behavioral Health Services: ASAM Level 3.7: Medically Monitored Intensive Inpatient Services

2022

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