ASAM 4th Edition

ASAM 4th Edition criteria analysis
in under 60 seconds.

CriteriaIQ analyzes your Kipu patient chart against ASAM 4th Edition criteria across all six dimensions — producing authorization-ready documentation for initial and concurrent review.

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Every ASAM dimension.
Every level of care.

CriteriaIQ scores all six ASAM 4th Edition dimensions with explicit risk ratings and an overall authorization probability score.

D1
Intoxication, Withdrawal, and Addiction Medication
Intoxication and Associated Risks · Withdrawal and Associated Risks · Addiction Medication Needs. CIWA-Ar and COWS scores from Kipu assessments integrated automatically.
D2
Biomedical Conditions
Physical Health Concerns · Pregnancy-related Concerns. Medical comorbidities and physical health factors scored against ASAM 4th Edition criteria.
D3
Psychiatric and Cognitive Concerns
Active Psychiatric Symptoms · Persistent Disability. Mental health comorbidities and cognitive factors affecting treatment intensity.
D4
Substance Use-Related Risks
Likelihood of Risky Substance Use · Likelihood of Risky SUD-related Behavior. Relapse risk and continued use potential scored against ASAM 4th Edition criteria.
D5
Recovery Environment Interactions
Ability to Function in Current Environment · Safety in Current Environment · Support in Current Environment. Social and environmental factors affecting treatment needs.

Initial and concurrent review
for every LOC.

CriteriaIQ covers the full spectrum of ASAM levels of care with dedicated analysis buttons for each.

🏠
3.7 Medically Managed Intensive Inpatient
High-intensity residential treatment. Initial and concurrent review with full six-dimension analysis and auth probability score.
🏠
3.5 Clinically Managed High-Intensity Residential
Non-medical residential treatment. Subdimensional risk ratings with continued-stay probability and discharge barrier documentation.
🏥
2.5 High-Intensity Outpatient (PHP)
Structured day treatment. Initial and concurrent ASAM 2.5 analysis with intensity of service documentation.
🧹
2.1 Intensive Outpatient (IOP)
Structured outpatient treatment. ASAM 2.1 analysis with medical necessity justification for IOP versus lower levels.
📋
Phone Review Scripts
Ready-to-read phone review scripts generated from ASAM analysis. Dimension-by-dimension talking points for payer calls.
Appeal Letters
ASAM-specific appeal letters generated in one click. Cites the exact ASAM criteria the payer used to deny the authorization.

From Kipu chart to
medical necessity documentation.

  • Open a patient chart in Kipu EMR with the CriteriaIQ extension installed
  • Click the appropriate ASAM button (Residential, PHP, or IOP — Initial or Concurrent)
  • CriteriaIQ scrapes clinical notes, medications, assessments, and diagnoses automatically
  • AI analyzes all data against ASAM 4th Edition criteria across all six dimensions
  • Complete medical necessity documentation generated in under 60 seconds
  • Phone review script and appeal letter available with one additional click
  • Clinical documents — psychiatry evals, H&P, biopsychosocial, progress notes
  • CIWA-Ar and COWS scores from Patient Assessments tab
  • PHQ-9, GAD-7, and BAM-R assessment scores
  • Current medications from Med Log, Medical tab, and Doctor Orders
  • Insurance information from Information Tab
  • ICD-10 diagnoses with DSM-5 specifiers
From the Blog
ASAM Criteria and Insurance Authorization →

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