Opioid Treatment Programs (OTPs) Medicare Enrollment Fact Sheet Opioid Treatment Programs (OTPs) Med 2025

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  1. Click ‘Get Form’ to open the Opioid Treatment Programs (OTPs) Medicare Enrollment Fact Sheet in the editor.
  2. Begin by gathering all necessary documentation, including your SAMHSA certification letter and organizational details. This will streamline your completion process.
  3. Fill out Section 1: Basic Information. Ensure you check the appropriate box for your application reason and provide your Medicare Identification Number and NPI.
  4. Complete Section 2: Identifying Information, ensuring that all details about your organization are accurate and match IRS records.
  5. In Section 3, report any final adverse legal actions or convictions as required. Be thorough to avoid delays in processing.
  6. Proceed to Section 4: Practice Location Information. List all practice locations where services will be rendered, ensuring accuracy in addresses and contact information.
  7. After completing the form, review all sections for accuracy before submitting electronically through our platform or via paper form.

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Medicare covers occupational therapy if its medically necessary and your doctor recommends the services. There is no limit on how many occupational therapy sessions Medicare will cover.
Only Medicare-enrolled OTPs can bill for HCPCS codes G2067 through G2080, and G2215 to G2216. All of the drugs that are FDA-approved for the treatment of OUD are currently covered by HCPCS codes G2067-G2073 and G2215 to G2216.
Medicare covers Opioid Use Disorder (OUD) treatment services for people with Medicare when you get them from a doctor or other health care practitioner, or through a more comprehensive Opioid Treatment Program (OTP).
An OTP shall maintain current procedures designed to ensure that patients are admitted to treatment by qualified personnel who have determined, using accepted medical criteria, that: The person meets diagnostic criteria for a moderate to severe OUD; the individual has an active moderate to severe OUD, or OUD in
Medicare does cover services to maintain or manage a beneficiarys current condition when no functional improvement is possible if the services are medically necessary and meet the skilled care requirements.
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Opioid Treatment Programs (OTPs) provide medications for opioid use disorder (MOUD). OTPs must be certified by SAMHSA and accredited by an independent, SAMHSA-approved accrediting body. We pay OTPs through bundled payments for OUD treatment services for people with Medicare Part B (Medical Insurance).

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