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Medicare Billing for Opioid Treatment Programs
Jan. 31, 2020
Beginning Jan. 1, 2020, Medicare will cover opioid use disorder (OUD) treatment services for Medicare beneficiaries when performed by Opioid Treatment Program (OTP) providers. Eligible OTP providers must be certified and accredited by the Substance Abuse and Mental Health Services Administration (SAMHSA). All Medicare, to include Medicare Advantage, professional and outpatient claims for these services should be filed with the new HCPCS codes specific to the Opioid Treatment Program. Additionally, Medicare has established a new Place of Service (POS) code 58 – Non-residential Opioid Treatment Facility.
You can learn more about filing Medicare OUD services by visiting www.cms.gov and viewing the OTPs Medicare Billing and Payment Fact Sheet. (These links lead to a third party site. That site is solely responsible for the contents and privacy policies on its site.) Should you have any additional questions, you may contact Provider Education by using the Provider Education Contact Form.
BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.