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Maryland MedicaidMedicaid · Coverage · Behavioral Health Administration Services Organization · MD · PsychiatryHigh impact

Updated Coverage of Brixadi for Opioid Use Disorders

Act
by Jan 1, 2025
Effective date
Jan 1, 2025
Identified
Jun 20, 2026

Summary

Maryland Medicaid now covers Brixadi (buprenorphine extended-release injection) for opioid use disorder effective January 1, 2025, through the Behavioral Health Administrative Services Organization (BHASO). Eligible providers (OTP, community-based SUD programs, and local health departments) must bill using new HCPCS codes J0577 and J0578 at specified rates. The policy supersedes PT 56-25 and explicitly prohibits reimbursement when medication is prescribed or obtained from pharmacy.

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What to do

by Jan 1, 2025 · 4 steps
01Billing team at eligible Maryland providers (OTP, community-based SUD programs, local health departments) must update billing systems to add HCPCS codes J0577 ($428.66 for ≤7 days therapy) and J0578 ($1,714.63 for >7 days therapy) for Brixadi administration.
02Configure system to bill only when Brixadi is purchased directly from manufacturer and administered on-site—block claims when medication is prescribed or obtained from pharmacy point-of-sale.
03Train clinical and billing staff on NDC codes (58284-208-01 through 58284-228-01) and billing restrictions.
04Contact Carelon at Provider.relations.MD@carelon.com for technical billing questions.
If missed: Failure to implement correctly will result in claim denials.

Codes mentioned

J0577J0578

Original notice

Updated Coverage of Brixadi for Opioid Use Disorders
health.maryland.gov no longer serves this document. We saved a copy on Nov 6, 2026.
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Related changes

See all Maryland Medicaid changes →
Updates to Reimbursement Rates and Coverage for Long-Acting Injectable Buprenorphine for Substance Use DisordersHighEffective Mar 1, 2026 · Behavioral Health Administration Services OrganizationCoverage of Brixadi for Opioid Use DisordersHighEffective Jan 1, 2025 · Behavioral Health Administration Services OrganizationPT 75-26: Updates to Reimbursement Rates and Coverage for Long-Acting Injectable Buprenorphine for Substance Use DisordersMediumEffective Mar 1, 2026 · Claims & BillingBrowse every Maryland Medicaid change in the policy list

Related policy hubs

Maryland Medicaid policiesMD policy changesPsychiatryCode J0577Code J0578

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