MedicaidDocumentationMedium impact
Provider Letter: Substance Use Disorder Inpatient Treatment Guidance
Kentucky Medicaid·KY · Psychiatry·Provider Letter
Effective date
Nov 15, 2021
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid has issued guidance for substance use disorder residential/inpatient treatment emphasizing that length of stay must be determined by individualized assessment rather than fixed 30/60/90 day models. Assessment and reassessment schedules are now specified by ASAM level of care with formal reviews required at least weekly for most levels.
Action Required
Immediately: Billing teams at substance use disorder treatment facilities must ensure documentation supports individualized length of stay determinations based on six-dimensional biopsychosocial assessments rather than predetermined timeframes. Update prior authorization requests to include ASAM level of care assessments and weekly reassessment documentation. Ensure care coordination documentation is present for all residential treatment claims to support medical necessity.