Medicare Coverage of Services in Opioid Treatment Programs

Link

https://www.cms.gov/medicare/payment/opioid-treatment-program

Sponsor

Centers for Medicare & Medicaid Services (CMS)

Description

Describes a benefit that covers opioid use disorder (OUD) treatment services under Medicare Part B medical insurance. Enables the Centers for Medicare & Medicaid Services (CMS) to make bundled payments to certified opioid treatment programs (OTPs) for OUD treatment services for an episode of care provided to Medicare Part B beneficiaries. Covers the following services under the benefit: opioid agonist and antagonist medications for opioid use disorder (MOUD) approved by the U.S. Food and Drug Administration (FDA), substance use counseling, individual and group therapy, toxicology testing, intake activities, periodic assessments, and intensive outpatient services.

Geographic Coverage

Nationwide

Topics

Reimbursement and Payment Models • Treatment