ASAM Criteria 4th Edition Case Vignettes - Payers

ASAM Criteria 4th Edition Case Vignettes - Payers

Created March 2026
On-Demand Course

Overview

In the ASAM Criteria Payer Clinical Case Vignette series, learners will develop skills for reviewing service requests by applying their understanding of The ASAM Criteria, 4^th Edition, through real-world influenced cases. Each scenario presents a service request for an individual who is either entering or continuing treatment for substance use disorder. Learners will practice reviewing service request information, assessing the Dimensional Admission Criteria, and approving or denying a level of care request. All cases include peer-reviewed rationales.

The target audience for this course includes counselors, social workers, administrators, clinical staff, medical students, managed-care medical directors, licensed health professionals (managed care payers) who conduct medical necessity reviews for SUDs, and any other healthcare professional who works with individuals with addictive, substance-related, and co-occurring conditions.

Learning Objectives

Upon completion, learners will be able to:

1. Review service requests using the ASAM Criteria, 4^th Edition, to assess the evidence provided to support the level of care.
2. Apply transition and continued service criteria to support care transitions.

Registration Rates for Package 

*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.

Membership Question?  Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.

Refunds & Cancellations

All ASAM eLearning Center refund requests must be made in writing to Education@ASAM.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or eLearning Center credit. Automatic full refunds will be made for any course with a live-course component that has been cancelled.

Open Registration: 03/06/2026 - 12/05/2028

Closed Access: 01/05/2029

Instructions

1. Click on the Contents tab to begin this activity.
2. Complete Modules 1-6. 
3. After each module click Complete Post Test to answer multiple choice questions. You will have 10 attempts to pass and must answer 67% of the total questions correctly.
4. Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window. 
5. Click Complete Presenter Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
6. Click Claim Certificate to claim your medical credits. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievement.

Need Assistance?

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Accreditation & Credit Designation Statements

Joint Accreditation Statement

In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credits Available

• Physicians: 3 Credits
• Nurses & NPs: 3 Nursing Contact Hours
• PAs: 3 Credits
• Social Workers: 3 Credit
• Interprofessional Continuing Education: 3 Credits
• Certified Counselors: 3 NBCC Contact Hours 

  • 

    American Society of Addiction Medicine has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7062. Programs that do not qualify for NBCC credit are clearly identified. American Society of Addiction Medicine is solely responsible for all aspects of the programs.

• NAADAC: 3 CE Credits

Maintenance of Certification (MOC)/Continuing Certification Program (CCP)

This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABP, ABIM, and ABS. By completing the online credit application and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.

• ABIM MOC Points: 1 Medical Knowledge
• ABP MOC: 1 Lifelong Learning & Self-Assessment
• ABS Continuing Certification: 1 Accredited CME
• ABA MOCA 2.0®*: 1 Lifelong Learning MOCA 2.0® is a trademark of the American board of Anesthesiology®. This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American board of Anesthesiology's (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, https://www.theaba.org/, for a list of all MOCA 2.0 requirements.

Additionally, this activity has been designed to satisfy the requirements of the following primary physician board certification requirements. Please confirm with your individual Board.

• American Board of Addiction Medicine (ABAM)
• American Board of Preventive Medicine (ABPM)
• American Board of Psychiatry and Neurology (ABPN)
• Royal College of Physicians and Surgeons of Canada (RCPSC)

Certificates for other professions

All participants may request a certificate of participation upon completion of the activity and an online evaluation confirming their participation. Learners are strongly advised to contact their professional licensing board or professional association to confirm this certificate will be accepted as evidence supporting continuing education requirements.

California Association for Drug/Alcohol Educators (CAADE)

This educational program is approved by CAADE: #CP40 999 1225.

California Association of DUI Treatment Centers (CADTP)

This educational program is approved by CADTP: #205.

California Consortium of Addiction Programs and Professionals (CCAPP)

This educational program is approved by CCAPP: #OS-20-330-0227.

Disclosure Information

In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education. Speaker disclosures are listed on the speakers tab.

See the attached pdf for a list of disclosures.