First Step Counseling

First Step Counseling, based in Sioux Falls, SD, is one of the SAMHSA-registered treatment programs operating in SD. The facility's programming is outpatient (IOP), not residential. What this page can help with is the frame — what to ask, what to verify, what to compare against.

Care levels at First Step Counseling

First Step Counseling is an outpatient-focused program (IOP) — patients live at home or in sober living and attend treatment sessions. This level of care is clinically appropriate for mild-to-moderate substance use disorder, or for patients stepping down from residential. The useful move is to have an ASAM-aligned assessment done before admission — ideally by someone outside the facility's admissions team — to confirm that the level of care offered here is what the clinical picture calls for.

Insurance and payment

Payment and insurance specifics for First Step Counseling are not fully documented in the SAMHSA registry — a direct admissions conversation is the reliable way to confirm what forms of payment are accepted and at what network-contract level. The single most useful pre-admission move on insurance is requesting the facility send you — in writing, by email — the specific benefits verification for your specific plan product. That document is the answer to most post-admission billing disputes.

Before you call

Before admission to First Step Counseling, three questions consistently produce the most useful information: (1) which ASAM level of care are you treating me at, and what is the clinical rationale; (2) can you send me a written Verification of Benefits for my specific insurance plan; (3) what is your policy on medication-assisted treatment for opioid use disorder — specifically, do you continue patients on buprenorphine or methadone during residential programming. If the clinical situation involves opioid use disorder, confirm explicitly whether First Step Counseling offers medication-assisted treatment — buprenorphine, methadone, or naltrexone. Programs that do not are operating outside the current standard of care.