How to Get Addiction Treatment in Minnesota: Comprehensive Assessments and Direct Access Explained

Minnesota no longer uses Rule 25. Today you start with a comprehensive assessment at a provider you choose. Here's how Direct Access works, what the assessment covers, what happens next and how to pay for treatment.

If you or someone you love needs help with alcohol or drugs in Minnesota, the first step is a comprehensive assessment. You no longer need to wait for the county to approve you. Under a system Minnesota calls Direct Access, you can go straight to a treatment provider you choose, get assessed and start care.

This guide explains how that process works, what to expect at the assessment, and how to pay for treatment if you have Medical Assistance, private insurance or no insurance at all.

If you are in crisis right now, call or text 988. In Minnesota you can also call **CRISIS (274747) from a cell phone or text MN to 741741 to reach a crisis counselor, as listed by the Minnesota Department of Health. If someone may be overdosing, call 911.

Rule 25 is gone. Here's what replaced it

For years, Minnesotans who needed publicly funded treatment had to get a "Rule 25" assessment, usually through their county. That ended in 2022. The Minnesota Department of Human Services (DHS) told providers that "the Rule 25 process will no longer be available after June 30, 2022," and that on July 1, 2022, Direct Access would become "the only process by which publicly paid substance use disorder (SUD) treatment services can be accessed in Minnesota" (DHS provider bulletin).

DHS describes Direct Access this way: it "allows an individual to go directly to a provider they choose to receive a comprehensive assessment and access care immediately." It also "removes barriers of timing associated with going through a placing authority, allows for individual choice and removes duplication of comprehensive assessments" (DHS Substance Use Disorder Reform).

Many people still search for a "Rule 25 assessment." If someone tells you that you need one, what you need today is a comprehensive assessment.

What is a comprehensive assessment?

DHS defines it as "a detailed evaluation by a qualified professional to diagnose the substance use disorder, screen for co-occurring mental health issues, assess risks and recommend appropriate levels of care" (DHS Direct Access FAQ).

The assessment is done by an alcohol and drug counselor who meets Minnesota's licensing standards (DHS SUD reform study guide). It follows the American Society of Addiction Medicine (ASAM) criteria, which look at your situation across several areas of life, including your personal strengths that support recovery (DHS state plan amendment).

In practice, the assessment is a conversation. It may also include a review of your medical, legal, mental health and treatment records, a physical screening, a check on whether you need help with withdrawal, and, with your permission, interviews with people close to you (Clay County).

Expect questions about:

What you use, how much and how often
How use affects your health, work, school, family and relationships
Past treatment and what helped or didn't
Withdrawal symptoms and medical concerns
Mental health, including depression, anxiety and trauma
Your living situation and whether home supports recovery
Legal issues, such as a DWI or court requirements
What you want from treatment

There are no wrong answers. The more honest you are, the better the recommendation will fit.

Who does assessments, and where to go

Licensed substance use disorder treatment programs do most comprehensive assessments. Some counties and tribes also do them if they are enrolled with Minnesota Health Care Programs and have qualified staff (DHS Direct Access FAQ). Many counties stopped doing assessments after 2022 and now help people find an assessor or coordinate care instead (Western Prairie Human Services).

To find a provider, you can:

Search Waypoint for Minnesota programs by city, type of care and insurance, or browse the Minnesota state page
Call your health plan's member services line and ask for in-network substance use providers
Use the resources DHS lists for finding an assessment, including its licensing look-up and the Minnesota Health Care Programs provider directory (DHS)
Ask your doctor, your county human services office or a hospital social worker for a referral

When you call a program, you can simply say: "I'd like to schedule a comprehensive assessment." Ask whether they take your insurance, how soon they can see you and whether they offer the assessment by video.

How fast should you be seen?

Minnesota law sets a clear expectation. When a licensed treatment program completes an assessment before services begin, the assessor must "provide the assessment within five days or at a later date upon the client's request, or refer the individual to other locations where they may access this service sooner" (Minn. Stat. 254A.19).

The same law says the assessor must also:

Give you information on payment options if you're uninsured or underinsured
Give you a notice of privacy practices
Provide a copy of your completed assessment if you ask for it

If a program has a waitlist, ask them to point you to another provider who can see you sooner.

You choose where to get treatment

This is the biggest change under Direct Access. The assessor recommends "the nature, intensity level, and duration of treatment," but you "can access any enrolled provider that is licensed to provide the level of service authorized, including the provider or program that completed the assessment" (Minn. Stat. 254A.19).

In plain terms:

You don't need a county referral. DHS says "a referral from a county or tribe to choose a provider is not required" (DHS Direct Access FAQ).
You can stay or go elsewhere. You can get treatment from the program that assessed you or take your assessment to a different program.
You can start at the recommended level or a lower one. The client chooses "which level of care they wish to utilize that is equal to or less than that which is recommended" (DHS Direct Access FAQ).
Your assessment can travel with you. With your signed release, a new provider can use your existing assessment and update it rather than starting from scratch (DHS Direct Access FAQ).

One exception: if a court ordered treatment, the court may require you to follow the assessment's recommendations. DHS notes that you can talk with the court if you can't or don't want to follow them (DHS Direct Access FAQ).

What the recommendation might look like

The assessment points you toward a level of care. Common options include:

Withdrawal management (detox) to get through withdrawal safely with medical support
Outpatient treatment, with a few hours of counseling and groups each week
Intensive outpatient programs (IOP), usually 9 or more hours a week while you live at home. Learn more in our guide to intensive outpatient programs.
Residential treatment, where you live at the program for a period of time
Medication for opioid or alcohol use disorder, such as buprenorphine, methadone or naltrexone, often combined with counseling. See what medication-assisted treatment is.
Treatment coordination and peer recovery support to help with housing, work and staying connected after treatment

DHS lists all of these among the substance use services available in Minnesota (DHS). For a side-by-side look at how they compare, read treatment levels of care explained.

How to pay for the assessment and treatment

DHS says that if you don't have insurance, or your insurance isn't enough, "you may qualify for a program that can pay for substance use disorder treatment services, such as a comprehensive assessment" (DHS).

Medical Assistance and MinnesotaCare

If you have Medical Assistance (Minnesota's Medicaid program) or coverage through a state health plan, "you already have coverage for Substance Use Disorder Services and do not need to apply for treatment coverage through the Behavioral Health Fund" (Sherburne County). If you have Medical Assistance without a health plan, you can go to any assessment and treatment provider enrolled with Minnesota Health Care Programs (Sherburne County). Substance use services are also available to MinnesotaCare members (DHS provider manual).

If you're in a health plan, call the member services number on your card to find in-network providers.

Private insurance

Most private health plans cover substance use treatment. Call the number on your card, ask what your plan covers and ask for in-network providers. Our guide on whether insurance covers rehab explains what to ask.

The Behavioral Health Fund

The Behavioral Health Fund is Minnesota's program for people who have no insurance or whose insurance doesn't cover the full cost of treatment (DHS). It used to be called the Consolidated Chemical Dependency Treatment Fund.

In general, you may qualify if you (DHS Q&A, June 2026):

Meet the program's household size and income limits
Don't currently have active Medical Assistance
Don't have insurance that covers 100% of the cost of substance use treatment
Live in Minnesota

If your insurance covers only part of treatment, the fund may pay the unpaid portion (DHS Q&A). The DHS Behavioral Health Fund eligibility page lists the current income limits by household size.

The process changed this year. On July 1, 2026, DHS took over eligibility decisions from counties and tribes (DHS). Here's what that means for you:

Apply to DHS, not your county. Online applications are preferred (Anoka County).
Expect a decision within 5 business days (Anoka County).
Approval covers 60 days. If eligible, "you will be granted 60 consecutive calendar days of eligibility to seek substance use disorder treatment paid for by the Behavioral Health Fund" (DHS).
You can reapply if you need more time in treatment (Anoka County).
The fund pays the provider directly, as long as the provider is enrolled with Minnesota Health Care Programs (DHS).

Some county websites still describe the older rules, such as applying through the county or getting six months or a year of coverage. DHS is the current authority, so go by its pages.

DHS also encourages people who qualify for the fund to use the process to start a Medical Assistance application (DHS bulletin). Medical Assistance can cover far more than substance use treatment, so it's worth applying if you might qualify.

Not sure where to start? Ask the program doing your assessment. The law requires them to tell you about payment options if you're uninsured or underinsured, and many will help you fill out the application.

Before the assessment: what to bring

Photo ID and your insurance card, if you have one
A list of medications, including doses
Names of current doctors or therapists
Dates and places of past treatment, if any
Court paperwork, if a judge or probation officer asked for an assessment
Questions you want to ask

If you're feeling sick from withdrawal, tell the program when you call. Withdrawal from alcohol, benzodiazepines and opioids can be serious, and they may want you to start with medical care.

If you're helping a family member

You can't get an assessment on someone else's behalf, but you can make the first step easier:

Look up a few programs together and offer to make the call with them
Offer a ride and sit in the waiting room
Help gather insurance cards, medication lists and paperwork
Remind them that they get to choose the program, which can make treatment feel less like something being done to them

Our guide on how to help someone you care about has more ideas for starting the conversation.

Frequently asked questions

Is a comprehensive assessment the same as a Rule 25?

They serve a similar purpose, but the comprehensive assessment replaced Rule 25 on July 1, 2022. It's a clinical service done by a treatment provider or qualified assessor, and you get to choose where you go for treatment afterward.

Do I have to go through my county?

No. Under Direct Access, you can go directly to a provider for your assessment and treatment. Your county may still be able to help you find a provider or coordinate care.

How long is an assessment good for?

DHS says the comprehensive assessment "does not have specific timelines (outside of licensing requirements)" for updates or how long it lasts. A new provider will review your most recent assessment and update it as needed (DHS Direct Access FAQ).

Can I do the assessment by video?

Many Minnesota programs offer telehealth assessments. Ask when you call.

I got a DWI. Is this the same assessment?

Courts and probation often require a substance use assessment after a DWI. Ask the court or your probation officer exactly what they need, and tell the program it's court-related when you schedule.

What if I don't agree with the recommendation?

You can choose a lower level of care than recommended, or ask another provider for a second opinion. Talk through your concerns with the assessor. If treatment is court-ordered, check with the court first.

Find a program in Minnesota

Waypoint lists hundreds of licensed substance use programs across Minnesota, including outpatient, intensive outpatient, residential, withdrawal management and medication treatment. Search Minnesota programs or start from the Minnesota state page.

You can also call the free, confidential SAMHSA National Helpline at 1-800-662-4357, 24 hours a day.

This guide is general information, not legal or medical advice. Rules and eligibility limits change, so confirm details with DHS, your health plan or the program you choose. Last reviewed October 14, 2026.