Opioid use disorder treatment services

Opioid use disorder treatment services

Medicare Part B (Medical Insurance)

 covers opioid use disorder treatment services in opioid treatment programs. The services include medication (like methadone and buprenorphine), counseling, drug testing, and individual and group therapy. Medicare covers counseling and therapy services in person and by virtual delivery (using 2-way audio/video communication technology, like a computer). Medicare pays doctors and other providers for office-based opioid use disorder treatment, including management, care coordination, psychotherapy, and counseling activities.

Your costs in Original Medicare

Under Original Medicare, you won’t have to pay any copayments for these services if you get them from an opioid treatment program provider who’s enrolled in Medicare. However, the Part B

Deductible [glossary]

 still applies. Talk to your doctor or other health care provider to find out where to go for these services. You can also visit Medicare.gov/contacts and select “Opioid Treatment Program Services” to find a program near you.

 

Things to know

Find an Opioid Treatment Program Services provider in your area.

 

Note

If you have both Medicare and Medicaid, Medicare is now the primary payer for OTP services. In states where Medicaid used to cover OTP services, Medicaid is now the secondary payer.

Medicare Advantage Plans must also cover opioid treatment program services. If you’re in a Medicare Advantage Plan, your current opioid treatment program must be Medicare-enrolled to make sure your treatment stays uninterrupted. If not, you may have to switch to a Medicare-enrolled opioid treatment program. Since Medicare Advantage Plans are able to apply copayments to opioid treatment program services, you should check with your plan to see if you have to pay a 

Copayment

.

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