It has been asserted that matching persons to an appropriate level of care will result in more positive and cost-effective treatment outcomes for drug and alcohol patients. The Center for Substance Abuse Treatment, through its Target Cities demonstration project, proposed the implementation of centralized intake and the use of comprehensive standardized assessment procedures as mechanisms for improving the treatment process. The American Society of Addiction Medicine (ASAM) criteria was implemented at central intake units (CIU). The placement decisions of the assessors employed by individual treatment agencies before implementation of the CIU were compared to the placement decision process of the CIU assessors. Some differences were found in the ways that assessors at a centralized intake, where treatment is not provided, made placement decisions as compared to how assessors at individual treatment agencies made recommendations. The CIU assessors’ treatment recommendations were associated less with patients’ preference and more highly related to what assessors believed to be the best treatment option or level of care for the patient. Substance abuse history, relapse potential, and legal mandates were consistently more influential in the decision making process of CIU assessors. The CIU assessors were more willing to rate the patients’ attitudes, intentions, and condition as they related to ASAM criteria than were the service delivery unit (SDU) assessors. It is encouraging that assessors conducting assessments at the CIU were more likely to consider the multiple needs of patients, enhancing their ability to make placements consistent with ASAM patient placement criteria. 6 tables, 7 references