Medicare Coverage of Services in Opioid Treatment Programs



Centers for Medicare & Medicaid Services (CMS)


Describes a benefit that covers opioid use disorder (OUD) treatment services under Medicare Part B medical insurance. Enables the Centers for Medicare & Medicaid Services (CMS) to make bundled payments to certified opioid treatment programs (OTPs) for OUD treatment services for an episode of care provided to Medicare Part B beneficiaries. Covers the following services under the benefit: opioid agonist and antagonist medication-assisted treatment (MAT) medications approved by the U.S. Food and Drug Administration (FDA), naloxone and overdose education, substance use counseling, individual and group therapy, toxicology testing, intake activities, and periodic assessments.

Geographic Coverage



Elderly People • Medication-Assisted Treatment (MAT) • Naloxone • Opioids • People with Disabilities • Policy • Reimbursement and Payment Models • Treatment