Division of Mental Health and Addiction Services

Please submit email inquires about the transition to Fee for Service to FFS.Transition@doh.nj.gov.

Provides clinical guidance for providers on completing a LOCI and communicating clinical/medical necessity to the IME Utilization Management staff:
Tips to Get Your Clinical/Medical Necessity Authorization Presentation (Feb 2016)

This PowerPoint provides information about the IME Phase II implementation, including full utilization management of managed initiatives, significant changes in NJSAMS, changes in claims and conversion of slot based contracts to Fee for Service:IME Phase II Training (May 2016)

New Jersey Substance Abuse Monitoring System (NJSAMS) documents

Initiative Specific ASAM Ambulatory, ASAM Residential and Enhancement excel sheets and, SFY 2017 Extension Request LOC parameters, click on triangle to the left of the link:
Contract > FFS Documents > Benefit/ Business Rule Package

For current FFS approved providers by FFS Initiative sorted by County, click on triangle to the left of the link:
Contract > FFS Documents > FFS Approved Provider lists

Fee For Service Network Revisions for SFY17-18
Information regarding the codes and the rate changes for SUD FFS Initatives implemented in July 2016.Fee for Service Revisions (SFY 17-18)

Payer of last resort:
Provides guidance on choosing payer source for clients in accordance with state and federal funding regulations:
NJ Family Care/Medicaid Reimbursement for Services Rendered (Payor of Last Resort 22, 2015)

This correspondence from NJ DMHAS’s Assistant Commissioner details the requirement that providers become Medicaid enrolled providers and the process by which to enroll:
Requirements to Become a Medicaid Provider (March 21, 2014)

General Overview of Phase I of the IME:
IME Overview

Individual descriptions of the IME functions and how they relate to provider operations:
IME Fact Sheets

FAQ’s from Phase I Implementation:
IME Frequently Asked Questions (July 30, 2015)

Flow chart of the IME Functions in NJSAMS for Phase I and preview of the Phase II implementation:
Basic IME Flow Chart

Description and information on the Service Capacity Management System used by the IME to make referrals to providers:
Service Capacity Management System (SCMS) - Provider Tip Sheet (June 2015)

Frequently Asked Questions for Phase II of the IME, including information about the Prior Authorization Process,. These questions were collated from the Phase II trainings conducted in May and June of 2016. (June 28, 2016):
IME Phase II FAQs (June 28,2016)