March 07, 2024

Opioid Use Disorder: Medicare Pays for Certain Treatment Services

Medicare pays for opioid use disorder (OUD) screenings performed by physicians and non-physician practitioners.

If you diagnose your pateint with OUD, We also pay for certain treatment services, including:

  • Evaluation management visits for medication management: Use these visits to provide medication management to make sure patients take medications (like buprenorphine) properly as part of their recovery process.
  • Office-based substance use disorder (SUD) treatment services: You can bill for a group of services for the treatment of SUDs in the office setting. Medicare pays for a monthly bundle of services (for patients who are prescribed buprenorphine or naltrexone in the office setting) for the treatment of OUD or other SUDs.
  • Opioid Treatment Program (OTP): Provide medications for opioid use disorder (MOUD), including methadone, buprenorphine, and naltrexone, as well as a range of other services including individual and group therapy, substance use counseling, and toxicology testing, for patients diagnosed with OUD. Consider referring your patient to an OTP if this specific MOUD is helpful to their recovery. OTPs may also furnish Intensive Outpatient Program services to treat OUD.

Visit Opioid Use Disorder Screenings & Treatment for more information, including coverage and coding.