Exhibit 2P - SAPTI 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 the Substance Abuse Prevention and Treatment Initiative (SAPTI) ASAM Residential LOC Authorization Parameters for State Fiscal Year 2025, effective July 1, 2024. It outlines the authorization parameters for various residential substance abuse treatment services, including Long Term Residential Tier 2 (7 days, 14 days, and 30 days), Inpatient Withdrawal Management, and Pre-Admission Residential. The document specifies the ASAM Levels of Care, CPT codes, maximum units per authorization, authorization time frames, daily and weekly limits, and the number of days at which an Extended Residential LOC (ERL) is needed or can be submitted. It also provides information on the authorization "red zone" and the annual client limits for adult services.
The document includes the rates per unit and the authorization values for each service type. It also identifies a shared service named "Detox - Free-Standing Residential (Sub-Acute)" with a rate of $161.33. The document is focused on the Substance Abuse Prevention and Treatment (SAPT) Fee for Service - Adult Residential ASAM Level of Care Authorization Parameters.
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Exhibit 2P - Substance Abuse Prevention and Treatment Initiative (SAPTI) ASAM Residential LOC Authorization Parameters SFY 2025 Effective 07/01/2024 Revised 04/08/2024
Service Assessment
Long Term Residential
Tier 2 (7 days)
Long Term Residential
Tier 2 (14 days)
Long Term Residential
Tier 2 (30 days)
Inpatient Withdrawal
Management
Modality/Type Pre-Admission Residential Residential Residential Residential
ASAM LOC N/A Level 3.5 Level 3.5 Level 3.5 Level 3.7 WM
CPT Code H0001 HF H0026T2 HF H0026T2 HF H0026T2 HF H0010 HF
Maximum units per Authorization 4 7 14 30 5
Authorization time frame (days) 30 7 14 30 5
Unit 30 minutes Per diem Per diem Per diem Per diem
Daily Limits 4 1 1 1 1
Weekly Limits 4 7 7 7 7
# of days at which initial ERL needed N/A 5
# of days at which ERL can be submitted N/A 3
Authorization RED ZONE (67% of annual allocation) N/A N/A
Adult Annual Client Limits (units) 16 N/A
Rate Per Unit 28.49$ $ 475.42
Authorization Value 113.96$ $ 1,129.31 $ 2,258.62 $ 4,839.90 $ 2,377.10
Shared Service Name N/A
Detox - Free-Standing
Residential (Sub-Acute)
N/A
N/A
$ 161.33
Long Term Residential
Substance Abuse Prevention and Treatment Initiative (SAPT) Fee for Service - Adult Residential
ASAM Level of Care Authorization Parameters
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SAPT
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