MedicaidCoverageLow impact
[Virginia] Expanding buprenorphine access to improve opioid use disorder outcomes
Anthem BCBS·VA · Psychiatry, Internal Medicine, Family Medicine +1 more·Provider Bulletin
We identified it
May 3, 2026
Summary
This is an informational provider bulletin from Anthem HealthKeepers (Virginia Medicaid) encouraging expanded use of buprenorphine for opioid use disorder treatment. The policy emphasizes making medication-assisted treatment (MAT) the standard of care, removing administrative barriers, and highlights that DEA X-Waiver requirements were eliminated as of June 27, 2023, allowing any DEA-registered clinician to prescribe buprenorphine. No billing code changes, prior authorization modifications, or coverage restrictions are introduced.
Action Required
No immediate billing action required. This is a clinical guidance bulletin, not a billing policy change. Billing teams should be aware that: (1) Providers may initiate buprenorphine treatment with increased frequency, which may result in more claims for medication, counseling, and follow-up visits; (2) No specific coding, prior authorization, or reimbursement changes are mandated by this bulletin; (3) Ensure claims for buprenorphine-related services are processed normally according to existing Virginia Medicaid fee schedules and authorization requirements. Forward to clinical leadership and providers for awareness of the clinical recommendations regarding MAT initiation and equity auditing.