ARM 37.27.906. MEDICAID SUBSTANCE USE DISORDERS SERVICES: TREATMENT REQUIREMENTS

(1) All Medicaid substance use disorder services must be determined medically necessary by a licensed health care professional within the scope of their Montana professional license. (2) Medical necessity includes documentation to support: (a) an appropriate level of care placement for service based upon the American Society of Addiction Medicine (ASAM) Criteria, Third Edition; Copyright 2013 by the American Society of Addiction Medicine, Inc.; http://www.asam.org/publications/the-asam-criteria/text/ ; and (b) an International Classification of Diseases – Revision 10 Clinical Modification (ICD-10-CM) diagnosis of a substance use disorder. (3) All services except assessment services must be based upon a treatment plan established with the member.