March 30, 2019

Rate Enhancements for Qualified Opioid Treatment and Outpatient Clinic Programs

Rate Enhancements for Qualified Opioid Treatment and Outpatient Clinic Programs
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Qualified Opioid Treatment Programs (OTPs) and Outpatient Programs can receive an increase in reimbursement rate for specific enhanced services.The approval of SPA 2016-0004 in March of 2019 provides an opportunity for enhanced reimbursement rates, 50% for Peer Advocate Services and 10% for services provided in Qualified OTP's.  Below please find information regarding these enhancements and their impact on current service rates.

 

  • Peer Advocate Services Enhanced Rate: Outpatient Providers can receive a 50% rate reimbursement for Peer Advocate Services by utilizing a special Rate Code when billing.
     
  • Qualified OTP's 10% rate enhancement: The 10% is not being provided across the board for all OTP's. OTP's will need to meet certain requirements in applying for this enhancement.  OASAS is in the process of developing guidance on the 10% enhanced OTP Rate and the process for providers to receive it.  Further information will be forthcoming.
     

The revenue calculators have been updated to account for the rate enhancements.  

 

Guidance

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