OTPs fully-certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by a SAMHSA-approved accrediting body can enroll in the Medicare program to bill for covered services.
We encourage OTPs to begin the enrollment process as soon as possible.
Beginning January 1, 2021, Medicare Part B covers hospital outpatient OTP services. Health care organizations may now apply on the Medicare Enrollment Application for Institutional Providers (CMS-855A (PDF)) or through the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) (837I) when they enroll in the Medicare Program. These providers will submit claims using the CMS-1450.
Review the OTP Medicare Enrollment Booklet (PDF) to learn:
Resources to Guide You Through the Process