Virginia Regulatory Town Hall
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Department of Medical Assistance Services
 
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Board of Medical Assistance Services
 
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12/3/21  4:36 pm
Commenter: VCAM

Opioid Treatment Services Supplement
 

Under Medical Necessity Criteria section, it indicates that the patient must have a primary diagnosis of OUD.  That means that patients who are being treated here for other substance use disorders, other than Opioids, don't get reimbursed for ARTS covered services, such as Care Coordination G9012.  We perform the care coordination services on patients with Opioid Use Disorders as well as other Substance Use Disorders and this diagnosis should be expanded to cover services for providers who treat a variety of drug abuse.  Suggestion to modify this section and update from OUD diagnosis to SUD diagnosis to meet the coverage guidelines.  Thank you for your consideration. 

CommentID: 116762