Insurance & cost
Medical necessity criteria for addiction treatment
Published November 6, 2024 · 7 min read · Updated April 2026
Reviewed for accuracy by licensed clinical professionals.
ASAM criteria assess six dimensions to determine appropriate level of care.
Six dimensions
Intoxication/withdrawal, medical conditions, emotional/behavioral, treatment acceptance, relapse potential, recovery environment.
Advocacy
Document all dimensions thoroughly when appealing denials.
Frequently asked questions
How do I find help?
Call SAMHSA at 1-800-662-4357 or search our directory.
Does insurance cover this?
Most insurance covers substance abuse treatment under mental health parity.
Is treatment effective?
Yes. Treatment reduces substance use by 50-70%.
Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.