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

Coverage of Brixadi for Opioid Use Disorders

Act
by Dec 31, 2024
Effective date
Jan 1, 2025
Identified
Jun 20, 2026

Summary

Effective January 1, 2025, Maryland Medicaid will begin covering buprenorphine extended-release injection (Brixadi) for opioid use disorder through the Behavioral Health Administrative Services Organization (BHASO). Eligible providers (OTPs, community-based SUD programs, and local health departments) must bill using new HCPCS codes J0577 and J0578 with specific reimbursement rates. The BHASO will not reimburse when medication is prescribed or obtained from pharmacy at point of sale.

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What to do

by Dec 31, 2024 · 6 steps
01Billing team must update billing system to recognize and process new HCPCS codes J0577 ($404.09 for ≤7 days therapy) and J0578 ($1,616.35 for >7 days therapy).
02Verify that your organization is one of the three eligible provider types (OTP-Provider Type 32, Community-based SUD Programs-Provider Type 50, or Local Health Department-Provider Type 35).
03Configure system to only process reimbursement when Brixadi is purchased from manufacturer and administered directly by provider—do NOT bill when medication is prescribed or obtained from pharmacy.
04Train billing staff on NDC codes 58284-208-01 through 58284-228-01 for proper claim submission.
05Contact Carelon at Provider.relations.MD@carelon.com with any billing questions.
06Claims submitted without proper configuration will be denied.

Codes mentioned

J0577J0578

Original notice

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 OrganizationUpdated Coverage 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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