Exhibit 2G - MATI ASAM Residential LOC Authorization Parameters.pdf
PDF 110 KB Posted
- Solicitation number
- 25DPP01060
- Issued by
- Mercer County, New Jersey
About this file
This document is an exhibit that outlines the Medically Assisted Treatment Initiative (MATI) ASAM Residential Level of Care (LOC) Authorization Parameters for State Fiscal Year 2025, effective July 1, 2024. It details the authorization parameters for various residential treatment modalities, including Halfway House, Long Term Residential Tier 2, Short Term Residential, and Inpatient Withdrawal Management. The document specifies the ASAM LOC, CPT codes, maximum units per authorization, authorization timeframes, daily and weekly limits, and the authorization value for each service. It also identifies the number of days at which an Early Recovery Lodging (ERL) is needed and when it can be submitted.
The document provides the adult annual client limits in units and the rate per unit for each service. It identifies Detox - Free-Standing Residential (Sub-Acute) 7 and Medically Assisted Treatment Initiative (MATI) Fee for Service - Adult Residential ASAM Level of Care as shared service names, with their respective authorization values.
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 2G - Medically Assisted Treatment Initiative (MATI) 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)
Inpatient Withdrawal
Management
Modality/Type Pre-Admission 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 WM
CPT Code H0001 HF H2034 HF H2034 HF H2034 HF H0026T2 HF H0026T2 HF H0026T2 HF H0018 HF H0018 HF H0010 HF
Maximum units per Authorization 4 7 14 30 7 14 30 7 14 5
Authorization time frame (days) 30 7 14 30 7 14 30 7 14 5
Unit 30 minutes 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
Weekly Limits 4 7 7 7 7 7 7 7 7 7
# of days at which initial ERL needed N/A 5
# of days at which ERL can be submitted N/A 3
Authorization RED ZONE (67% of annual allocation) N/A N/A
Adult Annual Client Limits (units) N/A N/A
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$ 2,377.10$
Shared Service Name N/A
Detox - Free-Standing
Residential (Sub-Acute)
N/A
Medically Assisted Treatment Initiative (MATI) Fee for Service - Adult Residential
ASAM Level of Care Authorization Parameters
Halfway House
N/A
N/A
$ 161.33
$ 99.43
Short Term Residential
N/A
Long Term Residential
N/A
$ 244.78
N/A
Page 1 of 1 DMHAS MATI
MATI
File details come from the government source that posted it. Updated .