A new Medicare benefit that goes into effect in January will benefit many Medicare beneficiaries and will positively impact MFTs who work in Opioid Treatment Programs (OTPs).
In 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act was signed into law. Among other things, this law creates a new Medicare Part B benefit beginning in 2020. Under this new law, Medicare beneficiaries will be able to receive opioid use disorder treatment services furnished at one of the 1,700 or so OTPs located throughout the country that are certified by SAMHSA.
AAMFT closely monitored the SUPPORT Act, as well as other opioid-related legislation, through the legislative process. Under this law, these opioid disorder treatment services include “substance use counseling by a professional to the extent authorized under State law to furnish such services” and “individual and group therapy with a physician or psychologist (or other mental health professional to the extent authorized under State law).” To help ensure MFTs were indeed eligible to participate in this Medicare-funded program, AAMFT submitted comments during the rule-making process after the legislation had been passed into law.
On November 1, the Centers for Medicare and Medicaid Services (CMS) released its final rule pertaining to Medicare coverage for opioid use disorder treatment in OTPs. A summary of this final rule can be found here. Under both the statute and final rule, LMFTs employed in OTPs would be allowed to provide substance use counseling and therapy to Medicare beneficiaries receiving opioid use disorder treatment services in these programs. This new law does not allow LMFTs to be recognized as providers able to bill Medicare; however, OTPs would contract directly with Medicare. Under this new benefit, LMFTs working in OTPs would be able to provide necessary therapy and substance abuse counseling to Medicare enrollees.
This new benefit will help many Medicare enrollees who have an opioid use disorder. If you’re an MFT currently working at an OTP, please feel free to contact us at firstname.lastname@example.org if you’d like to share your story. If you have any questions about this new law, please also feel free to email email@example.com.