Payment & Reimbursement

Provides an overview of how organizations can use NIATx practices and tools to implement or improve a buprenorphine treatment program.

Describes service delivery models and corresponding rate design tools for the provision of MAT to individuals with opioid dependence.

Includes information for healthcare professionals, professional and patient organizations, and community groups, including tips for getting started, fact sheets on the requirements for providing chronic care management in practices, and educational materials to share with patients.

Provides tips and advice about commonly used CPT codes for buprenorphine treatment; how to set up a cash-only buprenorphine treatment program; Medicaid, Medicare, and private insurance coverage for buprenorphine treatment; and cost of buprenorphine treatment to patients.

Provides an overview of the current prior authorization landscape, including the status of electronic prior authorization adoption; the toolkit also looks ahead to the future of prior authorization and industry efforts and changes that will create a more efficient process.

Provides lessons learned from organizations with established MAT programs, including making the business case for MAT, securing buy-in from staff, overcoming community resistance, paying for MAT, finding prescribers, obtaining licenses and credentials, screening and assessing patients, combining medication and therapy, and sustaining a MAT program.

Provides information on how to best address intake, billing, and coding procedures in community health centers, which are critical aspects in positive patient outcomes

Presents information about Medicaid coverage of MAT for opioid and alcohol dependence; covers treatment and cost-effectiveness and includes examples of innovative approaches in Vermont, Massachusetts, and Maryland

Provides an overview of prior authorization and tips to reduce the burden of prior authorizations in physician practices. It also discusses the future of prior authorizations, including remaining challenges and practice workflow adjustments, as well as advocacy regarding prior authorization at the State level.