Evernorth Provider - Resources - The ASAM Criteria®

The ASAM Criteria®

Evernorth uses The ASAM Criteria, developed by the American Society of Addiction Medicine (ASAM), for guidance in conducting medical necessity reviews of substance use disorder levels of care for all health plan business, unless contractual requirements, federal or state law require use of other clinical criteria.

Customers:

For Cigna Healthcare customers: To access the full guidelines and trainings copy and paste the following URL into your web browser:
https://my.cigna.com/web/secure/consumer/asam-criteria.
Then, log in to myCigna.com^® with your username and password. If you do not have a myCigna account, you can easily register for one.

For Evernorth customers: To access the full guidelines and trainings copy and paste the following URL into your web browser
https://well.evernorth.com/app/secure/asam-criteria and
Then, log in to well.evernorth.com with your username and password. If you do not have a well.evernorth.com account, you can easily register for one.

Behavioral Health Providers:

For Behavioral health providers: To access The ASAM Criteria (full guidelines and trainings) log into Provider.Evernorth.com. From the “Resources” drop-down, select Behavioral Health Resources > Doing Business with Evernorth > View Documents > The ASAM Criteria. If you do not have access to the provider portal, you can register here.

Document Title	Document Type	Last Updated
*The ASAM Criteria, 3^rd Edition* Evernorth uses The ASAM Criteria, 3^rd Edition to conduct substance use level of care medical necessity reviews for customers 17 years and under, unless contractual requirements and/or federal or state law require use of other specifically identified clinical criteria.
Educational criteria training for customers (developed by ASAM)	Online Resource	11/06/2024
Access The ASAM Criteria, including the full guidelines, using the instructions below: For Cigna Healthcare customers, copy and paste the following into your web browser -- https://my.cigna.com/web/secure/consumer/asam-criteria -- and then log in to myCigna.com^® with your username and password. For Evernorth customers, copy and paste the following into your web browser -- https://well.evernorth.com/app/secure/asam-criteria -- and then log in to well.evernorth.com with your username and password. For Behavioral health providers, you can access The ASAM Criteria, including the full guidelines and trainings, by logging in to Provider.Evernorth.com (see path above). Copyright 2015 by the American Society of Addiction Medicine. Reprinted with permission. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM.
*The ASAM Criteria, 4^th Edition* Beginning November 2024, Evernorth will use The ASAM Criteria, 4^th Edition to conduct substance use level of care medical necessity reviews for customers 18 years and older, unless contractual requirements and/or federal or state law require the use of other specifically identified clinical criteria.
ASAM is developing a video for customers, describing the principles, concepts, and use of The ASAM Criteria, 4^th Edition. This page will be updated when the video is available.	--	11/06/2024
Access The ASAM Criteria, including the full guidelines, using the instructions below: For Cigna Healthcare customers, copy and paste the following into your web browser -- https://my.cigna.com/web/secure/consumer/asam-criteria -- and then log in to myCigna.com^® with your username and password. For Evernorth customers, copy and paste the following into your web browser -- https://well.evernorth.com/app/secure/asam-criteria -- and then log in to well.evernorth.com with your username and password. For Behavioral health providers, you can access The ASAM Criteria, including the full guidelines and trainings, by logging in to Provider.Evernorth.com (see path above). Copyright 2024 by the American Society of Addiction Medicine. Reprinted with permission. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM.