Will Medicare and Medicaid cover substance abuse treatment and buprenorphine?
Medicare – Substance abuse treatment may be covered under Medicare if it is determined to be medically necessary and it is provided in an inpatient or outpatient treatment center that is Medicare-certified according to the HHS. Medicare does not generally cover prescription drugs that are prescribed or dispensed to individuals on an outpatient basis. If buprenorphine is administered by a Medicare-certified facility as a component of inpatient or emergency treatment such as detoxification or early stage stabilization treatment, rather than being a separate outpatient prescription, the medication’s cost could be covered during that episode of care, just as the cost for any other medication used in the treatment process is covered when administered within a certified program/facility. However, this reimbursement would only occur if the Medicare-certified facility had buprenorphine on its list of eligible drugs and if the patient received the treatment at the facility. There is currently n
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