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methadone maintenance

IGG Posted Mon 27th of June, 2016 13:06:04 PM
Could you please advise as to the appropriate code to use to bill Medicare Part B for medication management with methadone for patients enrolled in an outpatient methadone maintenance clinic (clinic dedicated to the service provision of opioid substitution therapy/opioid pharmacotherapy)
SuperCoder Answered Tue 28th of June, 2016 01:57:19 AM
Hi, As per Medicare policy, "Methadone may be covered if provided to hospital inpatients but not provided in outpatient clinics" Also, Methadone is not a Part D drug when used for treatment of opioid dependence because it cannot be dispensed for this purpose upon a prescription at a retail pharmacy. Please refer to following link for further clarifications.
Hope this helps. Thanks.

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