Exhibit 2N - RCE ASAM Residential LOC Authorization Parameters.pdf
PDF 107 KB Posted
- Solicitation number
- 25DPP01060
- Issued by
- Mercer County, New Jersey
About this file
This document is the Recovery Court Efficiency (RCE) ASAM Residential LOC Authorization Parameters for SFY 2025, effective 07/01/2024 and revised 04/08/2024. It outlines the authorization parameters for various types of adult residential substance abuse treatment services, including long-term residential (Tier 2) at 7, 14, and 30 days, short-term residential at 7, 14, and 30 days, and inpatient withdrawal management. The document specifies the ASAM Level of Care, CPT codes, maximum units per authorization, authorization timeframes, daily and weekly limits, and other details for each service type.
The document includes authorization value information, a shared service name of "Detox - Free-Standing Residential (Sub-Acute)" with a rate per unit of $161.33, and a "Short Term Residential" and "Long Term Residential" service with rates of $244.78 and an unspecified amount, respectively. There are no client annual limits or red zone authorization details provided.
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Text version
Exhibit 2N - Recovery Court Efficiency (RCE) ASAM Residential LOC Authorization Parameters SFY 2025 Effective 07/01/2024 Revised 04/08/2024
Service
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
ASAM LOC Level 3.5 Level 3.5 Level 3.5 Level 3.7 Level 3.7 Level 3.7 Level 3.7 WM
CPT Code H0026T2 HF H0026T2 HF H0026T2 HF H0018 HF H0018 HF H0018 HF H0010 HF
Maximum units per Authorization 7 14 30 7 14 30 5
Authorization time frame (days) 7 14 30 7 14 30 5
Unit Per diem Per diem Per diem Per diem Per diem Per diem Per diem
Daily Limits 1 1 1 1 1 1 1
Weekly Limits 7 7 7 7 7 7 7
# of days at which initial ERL needed 0
# of days at which ERL can be submitted 0
Authorization RED ZONE (67% of annual allocation) 0
Adult Annual Client Limits (units) 0
Rate Per Unit $475.42
Authorization Value $0 $0 $0 $0 $0 $0 $0
Shared Service Name
Detox - Free-Standing
Residential (Sub- Acute)
$161.33
Short Term Residential
$244.78
Long Term Residential
Recovery Court Efficiency (RCE) Fee for Service - Adult Residential
ASAM Level of Care Authorization Parameters
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RCE
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