Traditional MedicareAdministrativeMedium impact
Opioid Treatment Programs Medicare Coverage Effective January 1, 2020
Illinois Medicaid - HFS·IL · Psychiatry, Pain Management·Provider Notice
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Effective January 1, 2020, Medicare now covers Opioid Treatment Programs (OTPs) through bundled payments for opioid use disorder treatment services. For dual-eligible beneficiaries, Medicare became the primary payer, and OTPs must enroll in Medicare to receive reimbursement.
Action Required
By July 1, 2020: OTPs must complete Medicare enrollment to continue receiving reimbursement for dual-eligible beneficiaries. Contact Medicare enrollment Helpline at 877-908-8476 to begin enrollment process. After July 1, 2020, Medicaid will discontinue payments for dual-eligible beneficiaries if not enrolled in Medicare.