ASAM Criteria documentation alignment is the work of making an addiction treatment organization's assessment records, authorization handoffs, utilization review and referral documentation match the edition of The ASAM Criteria its state and payers require. It is for addiction service organizations implementing a new edition or answering payer findings. Integral Healthcare Solutions (IHS) aligns your documentation and handoffs to the ASAM Criteria; your addiction clinicians make every level-of-care decision.
Last reviewed: October 2026.
What are The ASAM Criteria?
The ASAM Criteria are published by the American Society of Addiction Medicine (ASAM). ASAM describes the current edition as "The ASAM Criteria, Fourth Edition An evidence-based framework for organizing addiction treatment systems, improving patient care, and facilitating recovery" (ASAM). Some states and payers may still require an earlier edition, so the edition that governs your documentation is set by your state and payer contracts and is confirmed at the start of each engagement.
ASAM also publishes tools for putting the criteria into practice: "ASAM offers a variety of tools aimed at helping clinicians, payers, managed care entities, and policymakers implement The ASAM Criteria effectively" (ASAM implementation tools). Two matter most for documentation:
- The Level of Care Assessment Guide. "The Level of Care Assessment Guide is intended to standardize decision-making related to level of care recommendation and selection and support utilization review and identification of immediate needs" (ASAM).
- Service request forms. ASAM lists "Downloadable service request forms for submission to payers. Admission and continued service request forms available" (ASAM).
The criteria are ASAM's intellectual property, and your organization works from its own licensed copy.
Who needs it and what triggers it
The buyers are addiction service organizations implementing the edition of the criteria that applies to them. The work usually starts with one of these events:
- A change of edition. A state or payer moves to the Fourth Edition and the organization's forms, assessment documentation and review procedures were built to an earlier one.
- Payer findings or denials. Authorization or continued-stay reviews show documentation that does not support the level of care requested.
- A new program or a new level of care. Opening a service means building the intake, review and handoff documentation from the start.
- Residential certification. A residential program pursues ASAM Level of Care certification by CARF, which "demonstrates a provider’s capacity to deliver one or more residential ASAM Levels of Care consistent with the ASAM Criteria ®" (CARF).
How IHS helps
IHS works through a fixed process against the edition of The ASAM Criteria your state and payers require:
- Edition check. IHS confirms from your payer contracts and state requirements which edition governs your documentation.
- Gap assessment. IHS reviews assessment documentation, authorization handoffs, utilization review and referral records against that edition.
- Document and evidence mapping. IHS builds a crosswalk from each requirement to a form and a named owner.
- Drafting. IHS drafts documentation templates, level-of-care review and handoff procedures, and staff training records. All clinical content is for your addiction clinicians to review and approve.
- Mock review. IHS runs a mock chart review of sample records against the drafted procedures.
- Readiness support. IHS drafts responses to payer findings for your team to review and send.
What your organization supplies: its licensed copy of the criteria, current forms, payer contracts, sample charts, and its addiction clinicians.
The limit: level-of-care assessments and treatment decisions belong to your clinicians. IHS drafts documentation and procedures; it does not assess patients or decide placement.
Related IHS pages: Accreditation Consulting and 42 CFR Part 2 compliance for substance use disorder records.
What to have ready
Gathering these items before the first working session shortens the gap assessment. Each ties to an ASAM or CARF source.
- Your licensed copy of the edition of The ASAM Criteria that applies to you, currently the Fourth Edition at ASAM (ASAM).
- The payer contracts and state requirements that name the edition, so the edition check has a written basis.
- Your current level-of-care assessment documentation, for comparison with ASAM's Level of Care Assessment Guide (ASAM implementation tools).
- The admission and continued service request forms you send to payers, and ASAM's downloadable versions if you use them (ASAM).
- Your utilization review procedure and recent review outcomes, since the Assessment Guide is meant to "support utilization review" (ASAM).
- Sample charts covering intake, continued stay and transfer for the mock chart review.
- Referral and handoff records between levels of care.
- If a residential program seeks CARF ASAM Level of Care certification: the adult levels you deliver, since "Certification is available for adult Levels of Care 3.1 , 3.5 , and 3.7 ." (CARF).
When the list is together, the introductory call is the place to start.
How it compares
Organizations aligning to the criteria usually weigh these routes. They can be combined.
| Route | What the sources say |
|---|---|
| ASAM Level of Care certification by CARF | For residential adult Levels 3.1, 3.5 and 3.7 (CARF). CARF states: "CARF’s certification program is the only program approved by the American Society of Addiction Medicine for the assessment, verification, and certification of residential substance use disorder treatment services" (CARF). |
| ASAM's own tools and training | ASAM lists implementation tools for clinicians, payers, managed care entities and policymakers, including the Level of Care Assessment Guide and service request forms (ASAM). |
| Internal alignment by clinical and quality staff | The organization's own staff revise forms and procedures against the edition that applies. |
| IHS documentation alignment | Edition check, gap assessment, crosswalk, drafted templates and procedures for clinician approval, mock chart review and drafted responses to payer findings. |
What it costs
ASAM sells The ASAM Criteria as a publication; we did not record its price. CARF does not publish a dollar fee for ASAM Level of Care certification on the pages we reviewed; it states: "A base fee is due with submission of each application. Other fees, if applicable, are due within ten calendar days of invoice" (CARF, Steps to certification). Verify current fees with ASAM and CARF. IHS scopes each engagement after a free introductory call.
What this is not
- IHS does not make level-of-care assessments or treatment decisions. Your addiction clinicians do.
- IHS is not a certifying body and does not grant or influence a CARF certification decision or a payer's authorization decision.
- This page is not legal advice, and IHS does not interpret ASAM's license terms for you.
Frequently asked questions
What are The ASAM Criteria?
ASAM describes The ASAM Criteria, Fourth Edition as an evidence-based framework for organizing addiction treatment systems, improving patient care and facilitating recovery. The criteria are published by the American Society of Addiction Medicine, and organizations use their own licensed copy.
Which ASAM Criteria edition does our state Medicaid program or payer require?
The pages we reviewed do not list which edition each state or payer has adopted. The answer is in your payer contracts and your state's requirements. Confirming the edition is the first step of every IHS engagement, because every form is built to it.
What documentation do payers expect to support an ASAM level-of-care decision?
ASAM publishes a Level of Care Assessment Guide intended to standardize level-of-care decision-making and support utilization review, and downloadable admission and continued service request forms for submission to payers. Each payer's own requirements are in its contract and policies. IHS maps both to your documentation.
How do we align intake assessments, treatment plans and continued-stay reviews with the ASAM Criteria?
Start from the edition that applies, then compare each record type against it. IHS does this as a gap assessment and a crosswalk from each requirement to a form and an owner, then drafts the templates and procedures for your clinicians to approve and tests them in a mock chart review.
What are ASAM service request forms and when do we use them?
ASAM lists downloadable service request forms for submission to payers, with admission and continued service request versions. Whether a payer requires them depends on the payer, so check your contracts.
What is ASAM Level of Care certification by CARF, and which levels does it cover?
CARF states that ASAM Level of Care certification demonstrates a provider's capacity to deliver one or more residential ASAM Levels of Care consistent with the ASAM Criteria. Certification is available for adult Levels of Care 3.1, 3.5 and 3.7.
How long does CARF's ASAM Level of Care certification take?
CARF states it schedules the survey during the six months following completion of the application process and issues the decision letter, Plan of Action form and certificate, if applicable, approximately six to eight weeks after the survey. Within 90 days of certification, the organization must submit a completed Plan of Action through Customer Connect.
Who in our organization must make level-of-care determinations?
Level-of-care assessments and treatment decisions belong to your clinicians. Who qualifies under your state rules and payer contracts is set by those documents. IHS drafts the documentation and review procedures; it does not make the determinations.
How do we train staff on the ASAM Criteria Fourth Edition?
ASAM offers implementation tools for clinicians, payers, managed care entities and policymakers. IHS drafts staff training records tied to your revised procedures, so the organization can show who was trained on what.
Can we use AI tools with ASAM Criteria content?
ASAM's implementation tools page states: "Inputting ASAM Criteria and other ASAM intellectual property into artificial intelligence is strictly prohibited" (ASAM implementation tools). Read ASAM's terms with your counsel before using any such tool.