Levels of Care for Addiction Treatment in Kentucky

Do People Need All Levels of Care?

Not everyone needs all levels of care for addiction treatment. The appropriate level of care depends on the individual’s specific needs, the severity of their substance use disorder, any co-occurring mental health conditions, and their personal circumstances. Some people may achieve lasting recovery with outpatient counseling alone, while others may require intensive inpatient treatment followed by sober living support. Treatment is often flexible, allowing individuals to move between levels as needed, for example, starting with detox, transitioning to residential care, and then stepping down to outpatient programs or aftercare. The goal is to provide the right support at the right time rather than forcing every person through every level of care.

How Long Does Each Level of Care Last?

The length of each level of care can vary depending on the individual’s needs, the severity of their addiction, and the treatment program’s structure. Outpatient programs may last anywhere from a few weeks to several months, with regular therapy sessions scheduled multiple times per week. Intensive outpatient programs (IOP) and partial hospitalization programs (PHP) generally run for several weeks, often around 4 to 12 weeks, depending on progress and clinical recommendations. Residential or inpatient treatment typically lasts from 30 days to 90 days, though some programs may extend longer for individuals who need more time to stabilize, develop recovery skills, and address co-occurring conditions. Detoxification, if required, usually lasts only a few days, but it is often followed by a higher level of care such as residential or intensive outpatient treatment.

ASAM Levels of Care

The ASAM Levels of Care are a nationally recognized framework developed by the American Society of Addiction Medicine to guide treatment for substance use disorders. They provide a structured way to match the intensity of care to an individual’s needs, considering factors such as withdrawal risk, medical and mental health conditions, readiness to change, and recovery environment. Most reputable rehabs use some form of ASAM-based assessment to determine the appropriate level of care, but it is not a legal requirement for every facility. The ASAM criteria are widely accepted in the United States and serve as a clinical standard for assessing the severity of a person’s substance use disorder and matching them to the level of care that best meets their needs. The ASAM criteria divide care into six main levels:

• Level 0.5 – Early Intervention: Services for individuals at risk of developing a substance use disorder. Focuses on education, screening, and brief counseling to prevent progression.
• Level 1 – Outpatient Services: Low-intensity treatment that allows individuals to live at home while attending therapy, counseling, and support groups. Suitable for mild to moderate substance use disorders.
• Level 2 – Intensive Outpatient/Partial Hospitalization: Provides more structured treatment. Level 2.1 is Intensive Outpatient (IOP) with several hours of therapy multiple times per week, while Level 2.5 is Partial Hospitalization (PHP), offering near-daily, full-day treatment without overnight stay.
• Level 3 – Residential/Inpatient Treatment: Provides 24-hour care in a structured environment. Level 3.1 is clinically managed, low-intensity residential care, while Level 3.3 and 3.5 are higher-intensity residential programs for individuals with more severe needs, including co-occurring mental health conditions.
• Level 4 – Medically Managed Intensive Inpatient: For individuals with severe addiction, acute medical complications, or high-risk withdrawal. Offers round-the-clock medical monitoring and intensive therapy in a hospital-like setting.
• Recovery Support Services: Although not always listed as a separate level, ongoing recovery support—including sober living, counseling, and peer support—is essential for maintaining long-term sobriety after formal treatment.

The ASAM Levels of Care differ from the general levels of care mentioned earlier because they provide a more standardized, clinical framework for matching a person’s needs to the intensity of treatment. While the general levels, such as outpatient, intensive outpatient, residential, and detox, offer a broad way to categorize care, they are often based on setting and structure rather than a detailed assessment of the individual’s clinical needs.

ASAM goes further by using six dimensions to evaluate each person, including withdrawal risk, biomedical conditions, emotional and behavioral conditions, readiness to change, relapse risk, and recovery environment. This approach allows clinicians to determine not just the type of program but the exact intensity of care a person needs, ranging from early intervention to medically managed inpatient services. In other words, while general levels provide a basic roadmap for treatment, ASAM offers a personalized, evidence-based guide that helps ensure the right level of care at the right time, improving safety and outcomes.

ASAM Levels of Care at Neartown Recovery

Neartown Recovery in Kentucky is certified to provide ASAM Level 3.1 and Level 3.5 residential levels of care, meeting national clinical standards for structured, therapeutic inpatient treatment for substance use disorders. Level 3.1, or clinically managed low-intensity residential care, offers a 24-hour supervised, structured residential environment where clients can live on-site while participating in recovery activities and treatment. This level of care is designed for individuals who need a stable, supportive setting to develop recovery skills, build personal accountability, and practice daily living skills in a community environment. Residents receive regular therapeutic support and focus on establishing healthier routines and habits as they work toward reintegration into daily life. Level 3.5, or clinically managed high-intensity residential care, provides a more intensive residential treatment experience with increased clinical services and structured therapeutic activities throughout the day. This level is appropriate for individuals who require a higher degree of clinical support, stabilization of behaviors related to addiction, and a safe, structured environment that helps prevent relapse. Participants typically engage in individual and group therapy, life skills education, relapse prevention planning, and other therapeutic interventions that support deeper recovery work. Being certified for both 3.1 and 3.5 levels allows Neartown to accommodate a range of clinical needs within residential care, from those needing steady support and skill-building to those requiring more intensive therapeutic engagement and supervision.

Levels of Care & Insurance Coverage for Addiction Treatment

Insurance coverage for addiction treatment often depends on the level of care a person requires, and understanding this relationship can help individuals access the right services without unexpected costs. Most insurance plans, including commercial insurance and Medicaid in Kentucky, cover a range of treatment options, but coverage can vary depending on medical necessity, program type, and the length of care.

Outpatient treatment, including counseling and therapy, is generally the lowest-intensity level and is widely covered by insurance. Intensive outpatient programs (IOP) and partial hospitalization programs (PHP) are typically covered when a clinician documents that a higher level of care is needed. Residential or inpatient treatment usually requires prior authorization and evidence that outpatient care would be insufficient, as it is more intensive and costly. Detoxification services may also require insurance approval, especially if medically supervised detox is needed to manage withdrawal safely.

Many insurance companies rely on ASAM criteria to determine medical necessity and the appropriate level of care. Using ASAM guidelines ensures that clients receive the right type and intensity of treatment while maximizing insurance coverage. After completing a primary treatment program, ongoing aftercare and sober living support may also be partially covered depending on the plan.