Issued: April 7, 2022
Effective May 1, 2022, Partners Utilization Management will no longer manage these two (2) Substance Use services: Outpatient Opioid Treatment (OOT) and Office Based Opioid Treatment (OBOT). Please refer to the table below for the service codes and modifiers:
| Medicaid Outpatient Opioid Treatment | State Outpatient Opioid Treatment | State Office Based Opioid Treatment |
| H0020 – Opioid Treatment Services | H0020 – Opioid Treatment Services | YA396 – Office Based Opioid Treatment Bundle |
| H0020 (U3) (OU) (OT) – Opioid Treatment Program Bundle
|
H0020 (U3) (OU) (OT) – Opioid Treatment Program Bundle | YA396 S3 – OBOT Maintenance |
| H0020 (U3) (OU) – Opioid Treatment Program Bundle | H0020 (U3) (OU) – Opioid Treatment Program Bundle | YA396 S2 – OBOT Stabilization |
| H0020 (OT) – Opioid Treatment Services
|
YA396 S1 – OBOT Assessment and Induction | |
| H0020 (U3) (BU) – Opioid Treatment Services |
COVID-19 flexibility codes for Outpatient Opioid Treatment do not require authorization:
H0020 (GT) (CR) – Opioid Treatment Audio/Visual
H0020 CR – Opioid Treatment Telephonic
H0020 (U3) (OU) (CR) – Opioid Treatment Program Bundle Telephonic
For information on Outpatient Opioid Treatment and Office Based Opioid Treatment benefit limits, please refer to the Medicaid and State Service Definitions:
https://providers.partnersbhm.org/service-definitions/
Also, please refer to the Medicaid and State Benefit Grids for service limits:
https://providers.partnersbhm.org/benefit-grids/
If you have additional questions regarding SAR submissions, please contact: