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Tags Posts tagged with "OTP"

OTP

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Photo by Markus Winkler on Unsplash

The Department of Drug and Alcohol Programs (DDAP) has issued Licensing Alert 02-2024, effective immediately, to inform opioid treatment programs (OTP) about the recent final rule issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) on February 2, 2024, concerning medications for the treatment of opioid use disorder (OUD). RCPA issued an alert to its members on February 1 announcing the final rule.

This rule modifies and updates regulations pertaining to OTP accreditation, certification, and standards for the treatment of OUD. The most crucial aspects of SAMHSA’s final rule include the permanent adoption of COVID-19 era flexibilities, allowing patients to receive more take-home doses of methadone, which is proven to enhance treatment retention and reduce illicit opioid use. The update also permits the initiation of methadone and buprenorphine treatment via telehealth through OTPs and removes stringent admission criteria, thereby improving access to care for individuals in need.

DDAP is currently reviewing the final rule, set to take effect on April 2, 2024, with a compliance deadline of October 2, 2024, and plans to issue a follow-up Licensing Alert soon. For further information, contact the Bureau of Program Licensure.

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The Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) in the Federal Register for November 18, 2022. Some of the key provisions contained in the final rule include (and are effective on January 1, 2023):

Medicare Telehealth Services

  • Addition of new HCPCS codes to the list of Medicare telehealth services on a Category 1 basis.
  • Implementation of the 151-day extensions of Medicare telehealth flexibilities, including allowing telehealth services to be provided in any geographic area and in any originating site setting.
  • Permission for physical therapists, occupational therapists, speech-language pathologists, and audiologists to provide telehealth services.
  • Listing of codes added to the telehealth services list are here.

Evaluation & Management (E&M) Visits

  • For CY 2023, CMS finalized changes for “Other E/M” visits that parallel the changes that were made in recent years for office/outpatient E/M visit coding and payment. Other E/M visits include hospital inpatient, hospital observation, emergency department, nursing facility, home services, residence services, and cognitive impairment assessment visits.

Behavioral Health

  • Proposal finalized to create a new HCPCS code (G0323) describing General Behavioral Health Integration performed by clinical psychologists or clinical social workers to account for monthly care integration where the mental health services provided are serving as the focal point of care integration.

Chronic Pain Management

  • Finalized a CY 2023 proposal to create two new G codes (G3002 and G3003) performed by physicians and other qualified health professionals describing monthly CPM for payment starting January 1, 2023.

Opioid Treatment Programs (OTPs)

  • CMS finalized the proposal to allow the OTP intake add-on code provided via 2-way, interactive, audio-video technology when billing for the initiation of treatment with buprenorphine using audio-video technology to start treatment with buprenorphine as authorized by the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) at the time the service is provided.
  • CMS also finalized the proposal to permit the use of 2-way, interactive, audio-only technology to start treatment with buprenorphine in cases where audio-video technology isn’t available to the patient and all other applicable requirements are met.
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