Level Description Score 0 Basic Services for Prevention and Maintenance 7 to 9 1 Recovery Maintenance and Health Management 10 to13 2 Outpatient Services 14 to 16 3 Intensive Outpatient Services 17 to 19 4 Intensive Integrated Services w/o 24 hour Psychiatric Monitoring 20 to 22 5 Non Secure, 24-hour Psychiatric Monitoring 23 to 27 6 Secure, 24-hour Psychiatric Monitoring 28
Your information will be encrypted.
Your browser does not support capabilities required for electronic signatures.
Click a signature you want to use: