Mix & Match
In the online LOCUS tool, which Level of Care Description do we NOT use for 2026 IRR testing?
A. Adult LOCUS levels of Care
B. Child/Adolescent CALOCUS Levels of Care
C. Child/Adolescent CALOCUS-CASII Levels of Care
B. Child/Adolescent CALOCUS Levels of Care
(Per 7/16 prep training)
*HOT TIP: Once you click on the level of care for your IRR question- you can often locate the answer in the first three paragraphs (Josh)
Which Adult & Geriatric Psychiatry subset would typically be selected when services are provided several hours per day but the member does not require 24-hour psychiatric care?
A. Behavioral Health Observation
B. Partial Hospital Program
C. Residential Treatment Center
D. Supervised Living
Answer: B ✅
Rationale: Partial Hospital Program is one of the Adult & Geriatric Psychiatry levels of care between inpatient and outpatient services. [Review Process Document]
Care Management Information in Adult & Geriatric Psychiatry appears:
A. For every level of care
B. Only in Residential Treatment Center reviews
C. Only for Inpatient reviews
D. Only for Outpatient reviews
Answer: C ✅
Rationale: Care Management Information appears when completing an Adult & Geriatric Psychiatry Inpatient review. [Quick Refe...y Products | PDF]
What score indicates Independent Criteria requiring admission to Level 6 (inpatient) regardless of the overall/composite score?
A. Score of 5 on Dim 1, 2 or 3
B. Score of 5 on Dim 1 only
C. Score of 4 on Dim 1, 2 or 3
D. Score of 3 on Dim 1, 2, 3
A. Score of 5 on Dim 1, 2 or 3
True or False? Level 2.5 programs are able to provide necessary supports that include:
True
(Information pulled directly from Level 2.5 subset note)
When preparing for InterQual IRR testing, you need to locate the definition of an "Episode Week." Which resource is most likely to provide it?
A. Provider Manual
B. Review Process Document
C. Benefit Grid
D. Authorization Letter
Answer: B ✅
Rationale: Review Process documents contain definitions and terminology such as Episode Day/Week.
Which InterQual Psychiatry product includes a Subacute Care level of care?
A. Adult & Geriatric Psychiatry
B. Child & Adolescent Psychiatry
C. ASAM Adult 4th Edition
D. ASAM Adolescent 3rd Edition
Answer: B ✅
Rationale: Subacute Care is listed as a Child & Adolescent Psychiatry level of care. [2026 IQ Ch...ew Process | PDF]
A 13-year-old female patient has a history of anxiety and PTSD due to physical and sexual abuse by her stepfather. She was recently in a local store when she was approached by her stepfather, who no longer resides in the home. He threatened her with physical harm, made inappropriate sexual remarks and attempted to grope her.
The patient’s symptoms have worsened since the encounter to include increased nightmares, depersonalization episodes, increasing social isolation and failing grades. Her outpatient therapist recommended Intensive Outpatient Program to manage her increasing symptoms.
What are the programming requirements for family, group or individual therapy at this level of care?
A. At least once per day
B. At least 6 contact hours per week
C. At least 9 contact hours per week
D. As specified by the therapist
B. At least 6 contact hours per week
Rationale: Level of care Informational notes are attached to each level of care within the criteria. This information is provided in the notes attached to Intensive Outpatient Program. For Intensive Outpatient Program, programming should be for at least 6 contact hours per week for children and adolescents including family, group or individual therapy and psychoeducation.
True or False
We are currently using LOCUS Version 20 and CALOCUS_CASII Version 2020 and there are 8 Dimensions evaluated in the LOCUS/CALOCUS criteria.
FALSE
While we ARE currently using LOCUS Version 20 and CALOCUS_CASII Version 2020, there are only SIX dimensions in the LOCUS/CALOCUS criteria.
True or False?
A patient might need integrated medical management if their needs require more than daily contact with a medical provider; they are unable to access adequate care externally; or they are assessed as needing integrated medical management to permit effective participation in addiction treatment.
False. A patient might need integrated medical management if their needs require more than WEEKLY contact with a medical provider
When criteria are met for Symptom worsening, what does it indicate to the reviewer?
A. Continued stay is appropriate.
B. The patient may require a more intensive LOC
C. The patient is clinically stable and discharge is expected on that day.
D. None of the above
B. The patient may require a more intensive LOC
According to ASAM Navigator, what are the key differences between a HIGH or MODERATE likelihood of imminent risky substance use/SUD-related behaviors and how quickly member is likely to return to use if no clinical intervention were provided?
A. Level of skills to avoid behaviors
B. Level of family/friends involvement in treatment
C. Frequency of clinical support received
D. Employment Prospects
E. Level of structure to maintain sobriety
F. A, B, D & E
G. A, C & D
H. A, C, E
H. A, C, E
Level of skills to avoid behaviors
Frequency of clinical support received
Level of structure to maintain sobriety
In The ASAM Navigator, "Non-Intensive" refers to services provided less than:
A. 5 days per week
B. 1 day per week
C. 3 days per week
D. Twice per month
C. 3 days per week
True or False
If a member has chronic symptoms or ongoing issues, they will be rated higher in that parameter/dimension
FALSE
In The ASAM Criteria, medical services are services that are directed and delivered by medical staff to address concerns in which Dimensions?
Dimensions 1, 2, and/or 3.
True or False?
In the ASAM Navigator 4th Ed Adult, Patients who can safely and effectively engage in outpatient care with recovery residence support can:
Self-transport safely between the recovery residence and outpatient care
Effectively connect with others in the recovery residence for peer support (and possibly utilize peer support from other sources in the community like 12 step fellowships)
Resist environmental triggers for risky substance use or SUD-related behaviors for brief periods when outside of the recovery residence, or reliably seek help when they're having trouble
True (Source: Informational Note- Dim 5, 3.5 LOC)
Name 3 of the 5 examples of negative, but not seriously destabilizing consequences outlined in Dimension 4 for Risky substance use/SUD-related behaviors. (Key words are acceptable)
Inability to establish/maintain relationships
Inability to establish/maintain steady employment
Family/Interpersonal Conflict
Minor Legal Challenges
Minor Financial Challenges
True or False? A 46 year old woman was admitted last week to inpatient psychiatric due to a suicide attempt. Facility UR is requesting 3 additional days. Last night the night nurse administered Trazodone due to members insomnia. This PRN meets for the criteria "PRN medications given at least 2 x within the last 24 hours to control symptoms or adverse effects".
False.
Rationale: WWYDW- PRN medications are related to symptom necessitating continued stay and not intended for insomnia.
Fill in the blanks: The AACP recommends using LOCUS to assess adults in age range _____ and CALOCUS_CASII with children and adolescents in age range _______.
A. 18 and above, ages 6-17
B. 21 and above, ages 6-20
C. 16 or older, ages 5-15
A. 18 and above, ages 6-17
True or False?
Patients whose addiction medication needs can be addressed in any level of care include:
(1) Patients who have initiated MOUD;
(2) Patients who do not have a history of poor outcomes with clinically managed care;
(3) Patients who are not anticipated to need more than weekly medical management when initiating addiction medications.
False: Patients who will not initiate MOUD, (not patients who have initiated MOUD)
True or False: For InterQual Adult & Geriatric, Inpatient LOC reviews, for the selection: "paranoia or persecutory delusions directed at a specific individual or group", the clinical information must clearly indicate with whom the paranoia is directed OR specifically name the individual or group that is the focus of the persecutory delusions.
False.
Rationale: WDYKW Per Optum: The paranoia does not have to be directed at a person but it does need to be serious enough to warrant inpatient stay. If there is documentation to support the persecutory delusions are in reference to an individual ( whether specifically named or not ) the reviewer may select the criteria
True or False: Instrumental ADLs (IADLs) are more complex tasks that involve interactions with others and with the environment and enable a person to live independently. People with mental illness and poor IADLs may be unable to live without structured support. All of these are examples of IADL's according to InterQual: cooking, cleaning, managing finances, communicating with others, and traveling outside the home (e.g., shopping, attending appointments).
True
Which of the following statements about using the LOCUS_CALOCUS-CASII instruments are NOT true?
A. Each dimension has a 1-5 point rating scale
B. Only one criterion needs to be met for that rating to be selected
C. It's important to read between the lines on every IRR test question to get the correct answer.
D. The instrument includes a dimension for treatment resources.
C & D are NOT TRUE
True or False:
The LOCUS/CALOCUS criteria are designed to determine the most appropriate level of care regardless of the diagnosis.
TRUE
Which 2 of the following non-life-threatening pregnancy complications may require frequent medical monitoring in a medically managed addiction treatment program according to the The ASAM Criteria 4th ed., Chapter 10, "Dimensional Admission Criteria" - Dimension 2, "Pregnancy-related concerns" decision rules:
A. Uncontrolled UTI
B. Chronic HTN
C. Patient history of 3rd trimester miscarriage
D. Stable gestational diabetes
E. A & B
F. B & D
G. All of the above
F. B & D (Chronic HTN & Stable gestational diabetes)