🏥 ASAM 2.5 — PHP Authorization

ASAM 2.5 PHP Authorization Software
for Kipu EMR

CriteriaIQ automates ASAM Level 2.5 Partial Hospitalization Program authorization directly inside Kipu EMR. PHP requires a unique double justification — why 24-hour residential care is NOT needed, and why IOP is NOT sufficient. CriteriaIQ documents both, calculates a PHP-specific auth probability, and generates concurrent reviews from the most recent chart documents.

Start Free Trial See PHP Criteria
ASAM 2.5 PHP Level of Care Criteria

Daily treatment. Home nightly. The hardest level to document.

PHP requires 20+ structured hours/week with daily clinical monitoring — but the patient must be stable enough to return home each evening. Documenting the clinical rationale for this "middle ground" is harder than residential or IOP.

Why PHP — Not Residential
✓Withdrawal stable — CIWA-Ar low/mild; overnight monitoring not medically required
✓Medical status not requiring 24-hour nursing monitoring
✓Patient can safely manage basic ADLs and return to a safe environment nightly
✓Risk level does not require immediate crisis intervention capacity overnight
Why PHP — Not IOP
✓Active psychiatric symptoms require daily monitoring and clinical assessment
✓Medication initiation or significant change requires daily response monitoring
✓Daily structured programming required to prevent clinical deterioration
✓Moderate-severe functional impairment needing daily rehabilitative structure
✓PAWS symptoms requiring daily clinical support and monitoring
CriteriaIQ PHP output includes: Auth probability (PHP-specific rubric), "Why not residential" clinical justification, "Why not IOP" clinical justification, key dimensional drivers (Active Psychiatric, Ability to Function, Readiness to Change), PAWS documentation, CIWA-Ar score cited, full medication list, and phone review script.
Auth probability rubric

A PHP-specific point rubric — not adapted from residential

PHP authorization probability is calculated from a rubric built specifically for the PHP level — different weights than ASAM 3.7/3.5 residential. The key drivers are psychiatric symptom severity, functional impairment, and PAWS documentation.

Active Psychiatric (D3) 2A/2B +30 pts — Daily monitoring clinically required
Ability to Function (D5) C/D +20 pts — Moderate-severe impairment
Readiness to Change (D4) D/E +15 pts — Low readiness, structured daily programming needed
PAWS documented in chart +8 pts — Supports PHP over IOP
PHQ-9 ≥ 15 +8 pts added to SI domain
GAD-7 ≥ 15 +6 pts added
CIWA-Ar ≤ 9 (mild/resolved) +5 pts — Supports PHP appropriateness (not residential)
Failed IOP or outpatient prior +10 pts — Prior LOC failure justifies PHP
ASAM 2.5 — PHP Initial Authorization
✓ Meeting
PHP Auth Prob
82%
Key Drivers
Active Psych: 2A (+30)
PAWS: ✓ (+8)
Function: C (+20)
CIWA: 6 Mild (+5)
Why Not Residential
CIWA-Ar 6 (Mild) — withdrawal stable. No 24-hr monitoring need documented. Patient able to manage ADLs.
Why Not IOP
Active psychiatric 2A requires daily monitoring. PAWS affecting sleep/cognition. Medication titration requires daily response monitoring.
💊 Full-Chart Scan

Medications, PAWS, CIWA — all built in to every PHP analysis

🧬
PAWS as PHP Justification

Post-Acute Withdrawal Syndrome is a specific PHP authorization indicator. CriteriaIQ scans all progress and nursing notes for PAWS documentation and adds +8 pts to auth probability when found. Supports why IOP alone is insufficient.

⚖
CIWA-Ar Score Context

A low CIWA-Ar score (0-9) actually supports PHP authorization — it means withdrawal is stable (not requiring residential monitoring) but treatment is still needed. CriteriaIQ cites the CIWA score in both the "why not residential" and "withdrawal" subdimension justifications.

💊
Medication Management

Current medications from Medical tab and Med Log cited in Intensity of Service criteria. Active psychiatric medication titration documented as a reason daily monitoring is required — supporting PHP over IOP.

PHP authorization in under 60 seconds

Starter plan: $149/seat/month. Enterprise facility rate: $699/month for up to 15 seats. 14-day free trial, no card required.

Start Free TrialAll ASAM Levels →