LOCUS is the mental-health counterpart to ASAM. Six levels of care, six assessment dimensions, and a structured logic for placement decisions. Used by many commercial payers for psychiatric utilization review.
LOCUS — the Level Of Care Utilization System for Psychiatric and Addiction Services — was developed by the American Association of Community Psychiatrists (AACP) as a structured framework for mental-health placement decisions. It complements ASAM, which focuses specifically on substance-use disorders.
LOCUS is most commonly used by commercial payers and managed-care organizations to support mental-health utilization review, especially when a client has primary psychiatric severity rather than primary SUD severity. Many state Medicaid plans also reference LOCUS in their level-of-care criteria.
CALOCUS-CASII is the version for children and adolescents — same six-dimension structure adapted for developmentally appropriate framing.
LOCUS scoring uses six dimensions, with each scored on a 1–5 scale. A composite score then maps to a recommended level of care. The composite is the framework's recommendation — clinical judgment can deviate with documentation explaining why.
LOCUS levels range from low-intensity outpatient (Level 1) to acute psychiatric hospitalization (Level 6). The levels below are the reference framework. As with ASAM, payers will be looking for documented assessment across dimensions, not just the recommended level.
The lowest intensity of formal services. Clients are stable and in long-term recovery, with services focused on sustaining wellness — psychoeducation, medication management visits, peer support, and routine outpatient follow-up.
Traditional outpatient mental health services. Weekly to bi-weekly therapy plus medication management as needed. For clients with mild to moderate symptoms who can function in community settings without intensive support.
Intensive outpatient or partial hospitalization for mental health. Several hours per week of structured programming — groups, individual sessions, medication management — for clients whose symptoms are interfering significantly with functioning but who can live at home.
Daily structured programming with active psychiatric and medical monitoring. Clients live at home or in supported housing but attend programming most days. For clients with significant symptom severity, recent inpatient discharge, or high relapse risk requiring close professional oversight.
24-hour residential care with on-site nursing and regular psychiatric oversight. For clients whose symptoms preclude safe community living but who don't require acute hospital-level care. Often the step-down from acute inpatient or the step-up from intensive outpatient.
Acute psychiatric hospitalization. 24-hour nursing, daily psychiatric care, locked or secured setting as clinically indicated. For clients with imminent risk of harm to self or others, severe psychiatric instability, or medical complications of mental illness.
For programs treating co-occurring disorders (SUD + mental health, sometimes called dual diagnosis), both frameworks are relevant. The general convention:
Commercial payer LOCUS use mirrors ASAM use in substance-use treatment:
Navix Launch is our end-to-end service for new and growing treatment centers. We lead the project; our contracted consultant network across the US covers licensing, accreditation, payer contracting, staffing, and clinical setup. Our head of compliance owns the project plan.
