ASAM Criteria Changes for Adolescent and Transition-Aged Youth Substance Use Disorder Services: Effective December 1, 2026

Date: 10/14/26

Ambetter from WellCare of Kentucky is notifying providers of upcoming changes related to the American Society of Addiction Medicine (ASAM) 4th Edition Criteria for Adolescents and Transition-Aged Youth (TAY). These changes will take effect on December 1, 2026.

Key updates:

• New admission and continued stay criteria for adolescents and transition-aged youth.
• Changes to ASAM Levels of Care, including the addition of new youth levels of care and the removal of certain levels previously included in the adolescent criteria.
• Revisions to the Six Dimensions assessment, including renamed and reordered dimensions and the addition of a new Person-Centered Considerations dimension.
• New considerations for co-occurring conditions and early intervention services.
• Updated guidance for members 18 to 25 years of age who may qualify for either Transition-Aged Youth or Adult programming based on clinical presentation and treatment needs.

Providers should review their internal assessments, documentation, and treatment-planning processes to ensure alignment with the new ASAM criteria prior to the effective date.

For questions, please contact your Provider Relations representative.