Behavioral Health to Utilize The ASAM Criteria

January 22, 2014

The Blue Cross and Blue Shield of New Mexico (BCBSNM) Behavioral Health Program has adopted the American Society of Addiction Medicine Criteria (The ASAM Criteria): Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions to be utilized for the behavioral health clinical screening criteria for patients with addiction disorders for all levels of care. This change will apply to all commercial, retail and Medicare Advantage plans effective April 1, 2014.  BCBSNM currently utilizes The ASAM Criteria for Blue Cross Community CentennialSM.

The 2013 ASAM Criteria are designed to support multi-dimensional assessments and treatment, attending to the multiple needs of each person, not just his or her alcohol or drug use. There is also a greater emphasis on the need for integrated care and the need to address both the mental health and physical health disorders present in patients with addictions.

Clinical Review Criteria are available to physicians and other professional providers upon request relative to a specific care review decision. Please contact BCBSNM Behavioral Health at 1-888-898-0070 to initiate this request.

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