Medicare/Medicaid Will Cover Opioid Treatment Programs in 2020

Effective January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) will pay Opioid Treatment Programs (OTPs) through bundled payments for opioid use disorder (OUD) treatment services in an episode of care provided to people with Medicare Part B (Medical Insurance).

Under the new OTP benefit, Medicare covers:

  • U.S. Food and Drug Administration (FDA)-approved opioid agonist and antagonist medication-assisted treatment (MAT) medications
  • Dispensing and administration of MAT medications (if applicable)
  • Substance use counseling
  • Individual and group therapy
  • Toxicology testing
  • Intake activities
  • Periodic assessments

For dually eligible beneficiaries (those enrolled in both Medicare and Medicaid) who get OTP services through Medicaid now, starting January 1, 2020, Medicare will be the primary payer for OTP services. For more information visit the CMS site.

AZZLY is the ideal EHR/RCM solution for OTPs that are seeking stronger documentation and billing services. From scheduling, to intake, progress notes, labs, e-prescribing, EPCS, and PDMP and all billing and clearinghouse functions to support providers working in OTP.  AZZLY Rize supports both third-party and in-house billers. Our RCM is easy to use and accurate, with a 98% clean claim rate. AZZLY Rize is a true all-in-one solution dedicated to serve addiction treatment and behavioral healthcare providers supporting the treatment of each patient every step of the way from intake to reimbursement.

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