⚕ ASAM 4th Edition Software

ASAM 4th Edition Criteria Software
Built Inside Kipu EMR

Stop writing ASAM Service Request Forms by hand. CriteriaIQ reads your Kipu patient chart and completes all 12 ASAM subdimensional risk ratings, calculates ASAM 3.7 and 3.5 authorization probabilities, writes individualized dimensional treatment plans, and generates phone review scripts — in under 60 seconds.

ASAM 4th Edition Framework

Every subdimension. Every rating. Every time.

CriteriaIQ scores all 12 ASAM subdimensions from the patient's live Kipu chart — CIWA-Ar, COWS, PHQ-9, GAD-7, BAM-R, clinical notes, and assessments all factored in.

D1
Dimension 1 — Intoxication & Withdrawal Potential

Array

D2
Dimension 2 — Biomedical Conditions

Array

D3
Dimension 3 — Emotional/Behavioral/Cognitive

Array

D4
Dimension 4 — Readiness to Change

Array

D5A
Dimension 5A — Relapse / Continued Use

Array

D5B
Dimension 5B/C — Recovery Environment

Array

Authorization probability

Not a guess. A documented score with an explicit rubric.

ASAM authorization probability is calculated from a point-by-point rubric that maps directly to risk ratings — the same ratings insurance medical directors use when reviewing concurrent authorizations.

ASAM 3.7 — Sub-Acute Detox
Withdrawal risk Moderate (3A) = +18 pts · Withdrawal risk High (3B) = +24 pts · Intoxication Severe = +22 pts · Physical Health Unstable = +15 pts · Dimensional Driver bonus = +10 pts
ASAM 3.5 — Residential
Risky Substance Use High = +25 pts · Ability to Function Severe = +20 pts · Support Environment Absent = +20 pts · Safety in Environment High Risk = +15 pts · Psychiatric High = +10 pts

Every point is documented in the output. A UR nurse can explain every score in a peer-to-peer review call.

Example ASAM Analysis Output
ASAM 3.7 Auth Prob
87%
Sub-Acute Detox
ASAM 3.5 Auth Prob
62%
Residential
INTX
WD
MED
BIO
PSYCH
DIS
SUD
RISK
FUNC
SAFE
SUPP
PREG
✅ Overall Status: Meeting Criteria — Recommended LOC: ASAM 3.7 RTC
Dimensional Driver: Dimension 1 (Withdrawal Risk 3B = High) drives ASAM 3.7 authorization. Dimension 5C (Support absent) drives ASAM 3.5 consideration. Treatment plan addresses all 5 active dimensions.
Concurrent review

ASAM Continued Service Request Forms too

CriteriaIQ handles both initial ASAM Service Request Forms and ASAM Continued Service Request Forms for concurrent/continued stay reviews — across all three levels of care.

📅
Most recent documents first

Concurrent reviews pull clinical data from the past 7 days — progress notes, nursing notes, medical notes, case management notes, and doctor orders — sorted most recent first.

📈
Clinical trajectory scoring

Trajectory is scored as improving, plateauing, or regressing, with points added to the auth probability based on documented clinical evidence of current status vs. admission.

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Discharge barrier documentation

Specific discharge barriers from case management notes are extracted and listed — housing, outpatient placement, medication titration, legal holds — justifying continued medical necessity.

🏥 ASAM 2.5 & 2.1 — PHP and IOP

Outpatient levels get their own dedicated buttons

PHP and IOP authorization is not a scaled-down version of residential documentation. CriteriaIQ applies the correct ASAM 4th Edition criteria for each outpatient level — with the right justification logic for each.

🏥
ASAM 2.5 — Partial Hospitalization (PHP)
20+ structured hours/week · Daily monitoring · Home nightly

PHP authorization requires documenting why the patient needs daily structured treatment but does NOT require 24-hour residential care. CriteriaIQ documents both sides — why residential is not needed AND why IOP is insufficient.

PHP-specific auth probability rubric (Active Psychiatric 2A/2B = +30 pts, PAWS = +8 pts)
Explicit "why not residential" and "why not IOP" clinical justifications
CIWA-Ar cited to support PHP over residential (low/mild score)
PAWS symptoms documented as PHP continued-stay justification
Initial authorization + concurrent review buttons
🧩
ASAM 2.1 — Intensive Outpatient (IOP)
9+ hours/week · 3+ days/week · Community-based

IOP authorization requires justifying why standard outpatient (1.0) is insufficient — not just that the patient needs treatment. CriteriaIQ documents frequency of care needed, PAWS contribution, and the IOP schedule.

IOP-specific auth probability rubric (Readiness D/E = +20 pts, failed outpatient = +8 pts)
Explicit "why not outpatient 1.0" and "why not PHP" clinical justifications
PAWS documented as specific IOP justification indicator
IOP schedule documentation (days/week, hours/day, total hours)
BAM-R risk score integrated into readiness dimension
Initial authorization + concurrent review buttons
All three ASAM levels included in the Starter plan — ASAM 3.7/3.5 Residential, ASAM 2.5 PHP, and ASAM 2.1 IOP, initial and concurrent for each. That's 6 ASAM analysis buttons total, starting at $149/seat/month. For facilities, the Enterprise plan covers up to 15 seats for $699/month flat.
💊 Full-Chart Clinical Scan

Medications, CIWA/COWS, and PAWS — automatically

Every ASAM analysis performs a full-chart scan before calling the AI. No score or medication gets missed because it was on a different tab.

💊
Full Medication Scan

Medical tab, Med Log, Doctor Orders, and recent clinical notes — all scraped and deduplicated simultaneously. Up to 25 current medications with dosages, routes, and frequencies cited in every subdimension justification.

CIWA-Ar & COWS

Latest CIWA-Ar and COWS scores extracted from clinical documents and fed directly into Dimension 1 risk ratings. Severity interpretation applied automatically: CIWA ≥20 = Severe (supports residential); CIWA 6-9 = Mild (may support PHP).

🧬
PAWS Detection

Post-Acute Withdrawal Syndrome scanned across all progress notes, nursing notes, and psychiatry notes. Named PAWS and symptom clusters (insomnia, cognitive fog, irritability, cravings) both detected and cited as PHP/IOP continued-stay justification indicators.

FAQ

ASAM software questions

What ASAM version does CriteriaIQ use?
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CriteriaIQ uses ASAM 4th Edition — The ASAM Criteria®, published by the American Society of Addiction Medicine. This is the current edition used by most major insurers for level of care determination in substance use disorder treatment.
Does CriteriaIQ work for all ASAM levels of care?
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Yes — CriteriaIQ has dedicated initial and concurrent review buttons for all three main ASAM levels: ASAM 3.7/3.5 (Medically Monitored Residential / Sub-Acute Detox), ASAM 2.5 (Partial Hospitalization Program / PHP), and ASAM 2.1 (Intensive Outpatient Program / IOP). Each level uses its own criteria, point rubric, and clinical justification requirements — PHP explicitly documents why residential is not needed, and IOP documents why standard outpatient (1.0) is insufficient.
How does CriteriaIQ pull CIWA and COWS scores?
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CriteriaIQ scrapes the CIWA-Ar and COWS scoring forms directly from the Kipu patient chart in real time. Scores are extracted from the clinical documents tab and automatically incorporated into Dimension 1 (Withdrawal) risk rating calculations.
What happens if my Kipu chart is incomplete?
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CriteriaIQ identifies documentation gaps and lists them as "Actions Required" in the output. For example, if a CIWA score is missing or a biopsychosocial hasn't been completed, it flags those gaps and suggests the specific documentation needed to strengthen the authorization.
Can I edit the ASAM analysis before exporting?
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The overlay panel shows you the complete analysis before you export. You can open a full-page view, review all subdimension ratings, and export to a print-ready PDF from any active tab — Overview, Subdimensions, Form View, or Appeal Letter.

Complete your next ASAM form in 60 seconds

Open a Kipu chart, click Analyze, review your auth probability. 14-day free trial.