9103.1 Assessment and diagnostic services shall include the initial evaluation, initial and ongoing collection of relevant information, and subsequent monitoring of information about a beneficiary who needs access to ASARS treatment.9103.2 Assessment and diagnostic services shall include the following categories:- (a) Initial assessment and diagnostic services;

- (b) Comprehensive assessment and diagnostic services;

- (c) Ongoing assessment and diagnostic services; and

- (d) Brief assessment and diagnostic services.9103.3 The assessment instruments shall incorporate American Society for Addiction Medicine (ASAM) patient placement criteria.9103.4 The initial assessment and diagnostic services shall be required to determine an individual's need for substance treatment.9103.5 The comprehensive assessment and diagnostic services shall be required to initiate a treatment episode.9103.6 Initial, comprehensive, and ongoing assessment and diagnostic services shall include referrals, as well as development and refinement of treatment plans.9103.7 Brief assessment and diagnostic services shall be used to incorporate updates to a beneficiary's diagnosis or treatment plan prior to transfer into a different level of care. Brief assessment and diagnostic services shall also be used to pre-screen for hospitalization and prior to a beneficiary's discharge from ASARS treatment.9103.8 Initial and comprehensive assessment and diagnostic services shall be performed once per treatment episode.9103.9 Clinical care coordinators shall determine the frequency of ongoing and brief assessment and diagnostic services and note this information in the beneficiary's treatment plan.9103.10 A unit of assessment and diagnostic service shall be one (1) fifteen (15) minute increment, pursuant to Department of Health Care Finance's (DHCF) billing criteria.

9103.11 Assessment and diagnostic services shall be subject to limitations on scope, frequency, and duration. Beneficiaries who require services in excess of established limits shall require prior authorization from DHCF.

9103.12 Limitations for assessment and diagnostic services, per treatment episode are as follows:

(a) Initial assessment and diagnostic services shall not exceed four (4) units;

(b) Comprehensive assessment and diagnostic services shall not exceed sixteen (16) units;

(c) Ongoing assessment and diagnostic services shall not exceed ninety-two (92) units; and

(d) Brief assessment and diagnostic services shall not exceed eight (8) units.

9103.13 Initial assessment and diagnostic services shall be delivered by the following qualified practitioners:

(a) Registered nurses;

(b) Licensed Independent Social Workers;

(c) Licensed Professional Counselors; and

(d) Certified Addiction Counselors I and II.

9103.14 Comprehensive, ongoing, and brief assessment and diagnostic services shall be delivered by the following qualified practitioners:

(a) Physicians;

(b) Psychologists;

(c) Licensed Independent Clinical Social Workers; and

(d) Advanced Practice Registered Nurses.