Exhibit 2E - MAP SPB ASAM Residential LOC Authorization Parameters.pdf
PDF 109 KB Posted
- Solicitation number
- 25DPP01060
- Issued by
- Mercer County, New Jersey
About this file
This document is an exhibit that outlines the Mutual Agreement Program - State Parole Board (MAP SPB) ASAM Residential LOC Authorization Parameters for the State Fiscal Year 2025, effective July 1, 2024. It details the authorization parameters for various residential levels of care, including Halfway House, Long Term Residential Tier 2, Short Term Residential, and Inpatient Withdrawal Management. The document specifies the ASAM level of care, CPT codes, maximum units per authorization, authorization timeframe, unit details, daily and weekly limits, and the number of days at which an initial ERL is needed or can be submitted. The authorization value and shared service names are also provided for each service type.
The pricing details include the rate per unit for each service, as well as the annual client limits. This appears to be a fee-for-service adult residential program managed by the Department of Mental Health and Addiction Services (DMHAS) and the MAP SPB. The document does not provide information about the overall contract, procurement process, or any other non-essential details.
View the file
Other files
Show all 44
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Exhibit 2E - Mutual Agreement Program - State Parole Board (MAP SPB) ASAM Residential LOC Authorization Parameters SFY 2025 Effective 07/01/2024 Revised 04/08/2024
Service Assessment Halfway House (7 days)
Halfway House (14 days)
Halfway House (30 days)
Long Term Residential
Tier 2 (7 days)
Long Term Residential
Tier 2 (14 days)
Long Term Residential
Tier 2 (30 days)
Short Term Residential
(7 days)
Short Term Residential (14 days)
Short Term Residential (25 days)
Inpatient Withdrawal
Management
Modality/Type Pre-Admission Residential Residential Residential Residential Residential Residential Residential Residential Residential Residential
ASAM LOC N/A Level 3.1 Level 3.1 Level 3.1 Level 3.5 Level 3.5 Level 3.5 Level 3.7 Level 3.7 Level 3.7 Level 3.7 WM
CPT Code H0001 HF H2034 HF H2034 HF H2034 HF H0026T2 HF H0026T2 HF H0026T2 HF H0018 HF H0018 HF H0018 HF H0010 HF
Maximum units per Authorization 4 7 14 30 7 14 30 7 14 25 5
Authorization time frame (days) 30 7 14 30 7 14 30 7 14 25 5
Unit 30 minutes Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem
Daily Limits 4 1 1 1 1 1 1 1 1 1 1
Weekly Limits 4 7 7 7 7 7 7 7 7 7 7
# of days at which initial ERL needed N/A 10
# of days at which ERL can be submitted N/A 5
Authorization RED ZONE (67% of annual allocation) 10 10
Adult Annual Client Limits (units) 15 15
Rate Per Unit 28.49$ 475.42$
Authorization Value 113.96$ $ 696.01 $ 1,392.02 $ 2,982.90 $ 1,129.31 $ 2,258.62 $ 4,839.90 1,713.46$ 3,426.92$ 6,119.50$ 2,377.10$
Shared Service Name N/A
Detox - Free-Standing
Residential (Sub-Acute)
$ 99.43
Halfway House
141 147
$ 161.33
Short Term Residential
$ 244.78
Long Term Residential
Mutual Agreement Program - State Parole Board (MAP SPB) Fee for Service - Adult Residential
ASAM Level of Care Authorization Parameters
Page 1 of 1 DMHAS MAPSPB
MAPSPB
File details come from the government source that posted it. Updated .