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Methadone Maintenance Reimbursement Guidelines pdf

Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Feb 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid is changing methadone maintenance clinic billing from weekly to daily units effective February 1, 2018. Clinics must use HCPCS code H0020 for each day of service with specific modifiers, and many services previously billed separately are now bundled into the daily rate.

Action Required

Action needed
By February 1, 2018: Methadone maintenance clinics must update billing systems to use daily units instead of weekly units for HCPCS code H0020. Use modifier HG for take-home methadone doses and HF when medication is not dispensed but clinical services are provided. Stop billing separately for psychotherapy (90832, 90853), drug testing (80305), and psychiatric evaluations (90791) as these are now included in the daily rate. Obtain new prior authorizations through Beacon Health Options for 365 daily units instead of 53 weekly units. Claims for separately billed bundled services will be denied.

Affected Billing Codes

H0020
90832
90853
80305
90791