Exhibit 2K - RCI ASAM Residential LOC Authorization Parameters.pdf
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- Solicitation number
- 25DPP01060
- Issued by
- Mercer County, New Jersey
About this file
This document is an exhibit on the Recovery Court Initiative (RCI) ASAM Residential Level of Care (LOC) Authorization Parameters for the state fiscal year 2025, effective July 1, 2024. It outlines the authorization parameters for various residential treatment services, including Halfway House (7, 14, and 30 days), Long Term Residential Tier 2 (7, 14, and 30 days), Short Term Residential (7, 14, and 30 days), and Inpatient Withdrawal Management. Each service type is assigned an ASAM LOC, CPT code, maximum units per authorization, authorization timeframe, daily and weekly limits, and the authorization value. The document also specifies the number of days at which an initial Eligibility and Referral Letter (ERL) is needed and the number of days at which an ERL can be submitted. The annual client limits and the authorization "red zone" (67% of annual allocation) are also provided.
The document outlines the shared service names, units, and rates per unit for Detox - Free-Standing Residential (Sub-Acute), Halfway House, Long Term Residential, and Short Term Residential services. The Recovery Court Initiative (RCI) Fee for Service - Adult Residential ASAM Level of Care Authorization Parameters are also detailed in the document.
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Text version
Exhibit 2K - Recovery Court Initiative (RCI) ASAM Residential LOC Authorization Parameters SFY 2025 Effective 07/01/2024 Revised 04/08/2024
Service 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 (30 days)
Inpatient Withdrawal
Management
Type/Modality Residential Residential Residential Residential Residential Residential Residential Residential Residential Residential
ASAM LOC 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 H2034 HF H2034 HF H2034 HF H0026T2 HF H0026T2 HF H0026T2 HF H0018 HF H0018 HF H0018 HF H0010 HF
Maximum units per Authorization 7 14 30 7 14 30 7 14 30 5
Authorization time frame (days) 7 14 30 7 14 30 7 14 30 5
Unit Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem Per diem
Daily Limits 1 1 1 1 1 1 1 1 1 1
Weekly Limits 7 7 7 7 7 7 7 7 7 7
# of days at which initial ERL needed 10
# of days at which ERL can be submitted 5
Authorization RED ZONE (67% of annual allocation) 10
Adult Annual Client Limits (units) 15
Rate per Unit 475.42$
Authorization Value $ 696.01 $ 1,392.02 $ 2,982.90 $ 1,129.31 $ 2,258.62 $ 4,839.90 1,713.46$ 3,426.92$ 7,343.40$ 2,377.10$
Shared Service Name
Detox - Free-Standing
Residential (Sub- Acute)
Halfway House
300 60
201 181
Long Term Residential
$ 244.78 $ 161.33 $ 99.43
Short Term Residential
Recovery Court Initiative (RCI) Fee for Service - Adult Residential
ASAM Level of Care Authorization Parameters
Page 1 of 1 DMHAS RCI
RC
File details come from the government source that posted it. Updated .