MedicaidPrior AuthMedium impact
MAB2024020601
Pennsylvania Medicaid (DHS)·PA · Psychiatry, Pain Management, Family Medicine +2 more·Provider Bulletin
Effective date
Feb 6, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is removing the 24 mg daily dose limit for sublingual buprenorphine used to treat opioid use disorder, allowing higher doses without prior authorization. This change reflects new research showing higher doses improve treatment retention in the fentanyl crisis era.
Action Required
Immediately: Review current prior authorization workflows for sublingual buprenorphine prescriptions. Pharmacy staff should note that doses above 24 mg/day for opioid use disorder treatment no longer automatically require prior authorization. Update internal reference materials and quantity limit lists from the Pennsylvania Medicaid website. Monitor for updated quantity limits that will support this guideline change.