Diagnostic Assessments

Service Definition and Required Components

A diagnostic assessment is an intensive clinical and functional evaluation of a beneficiary’s mental health, intellectual and developmental disability, or substance use condition. A diagnostic assessment determines whether the beneficiary meets medical necessity and can benefit from: mental health, intellectual disability, developmental disability, or substance use disorder services based on the beneficiary’s diagnosis, presenting problems, and treatment and recovery goals.

It evaluates the beneficiary’s level of readiness and motivation to engage in treatment. This assessment is designed to be delivered in a team approach that results in the issuance of a report that provides the clinical basis for the development of the beneficiary’s treatment or service plan. The written report must be kept in the service record.