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:

UMquestions@partnersbhm.org