** Program Sponsors – We strongly encourage you to forward this message to your office managers, billing/coding and administrative staff. **
We encourage all fully-certified Opioid Treatment Programs (OTPs) to enroll in Medicare now. As you submit your enrollment application, make sure you include all required documentation. If you submit an application without all documentation, it will delay processing and your ability to bill Medicare. Read the enrollment fact sheet (PDF) for more information on enrolling in Medicare, and for a list of all required documents. Make sure your application includes:
- Detailed organizational chart (like the one used for SAMHSA certification) showing the roles of your managing employees
- Signed provider agreement (PDF)
Even if your program hasn’t treated Medicare patients in the past, enrolled OTPs can now bill Medicare for treatment of eligible patients. Read the billing & payment fact sheet (PDF) for more information on billing for OTP services.
A few reminders for OTP providers:
Find Medicare-Enrolled OTPs
- A list of Medicare-enrolled OTPs is now available and includes the OTP number assigned by the Substance Abuse and Mental Health Services Administration, the National Provider Identifier or NPI, address, and the date they enrolled in Medicare. The list is updated every two weeks.
Frequently Asked Questions (FAQs)
- Medicare-Enrolled OTPs: Use Place of Service (POS) Code 58 on Claims
Only the new POS code 58 for nonresidential opioid treatment facilities can be used on OTP Medicare claims.
- We continue to update the FAQs on our webpage. Look for the **NEW** designation to easily find the latest information.
Message Archive
Visit our Messages to OTPs page to read all messages we’ve sent to OTPs since we released the final rule on November 1, 2019.