HCPCS code
Opioid treatment program (methadone and buprenorphine)
CMS description
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)
In the order to send them
Why these codes
Opioid treatment programs bill as outpatient substance use facilities; drug addiction is the specific benefit.
If a payer returns nothing
Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.
Sources
CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice