RetiredCareSourcePolicy N/A

Buprenorphine Treatment Providers - AR PASSE

Defines credentialing, training, registration, and coverage conditions for providers prescribing or dispensing buprenorphine for opioid use disorder within the Arkansas PASSE program, affecting physicians, advanced practice nurses, and other qualifying practitioners.

Policy Summary

PayerCareSource

PolicyBuprenorphine Treatment Providers - AR PASSE

Policy CodePolicy N/A

Change TypeClarified (non-material)

Effective Date12/01/2022

Next Review DateN/A

Key ActionPrescribers must be registered with the DEA and hold the special identifier for buprenorphine prescribing and complete required HHS-recognized training.

SourceLink

POLICY UPDATE CHANGES

Updated nurse practitioner requirements were added during a prior revision.

12/01/2022version effective

05/31/2023archived

NP-SUDMedEdAPRN training

DEA+Xprescribing requirement

Coverage criteria for buprenorphine prescribers

Covered when ALL of the following provider credentialing, registration, training, and practice conditions are met:

ALL of the following

ALL of the following
- ALL of the following
  - Unrestricted MD or DO license is required for physician prescribers; plus ONE of the following: subspecialty certification in addiction medicine by the American Board of Preventive Medicine, Certification by the American Board of Addiction Medicine, subspecialty certification in addiction psychiatry by the American Board of Psychiatry and Neurology, completion of an accredited residency/fellowship in addiction medicine or addiction psychiatry, or a certificate of added qualification in addiction medicine from the American Osteopathic Association.
ALL of the following

Policy Summary

PayerCareSource

PolicyBuprenorphine Treatment Providers - AR PASSE

Policy CodePolicy N/A

Change TypeClarified (non-material)

Effective Date12/01/2022

Next Review DateN/A

Key ActionPrescribers must be registered with the DEA and hold the special identifier for buprenorphine prescribing and complete required HHS-recognized training.

SourceLink

On This Page

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Coding and billing guidance

Coding guidancemixed

No specific CPT/HCPCS/ICD-10 codes specified in this administrative policy.

Patient limit implication

Policy statementThis policy references the Comprehensive Addiction and Recovery Act (CARA) and related statutes as influencing prescriber patient limits for buprenorphine dispensing, but does not specify any numeric patient-limit thresholds within the document.

Implication for prescribersPatient-limit adjustments may be governed by federal statutes (e.g., CARA) and applicable DEA waivers or identifiers rather than by this policy's text.

Operational impactCoverage and credentialing decisions should account for current federal/state patient-limit rules even though no numeric limits are stated here.

Provider registration, training, and required actions

Prior Authorization

DEA registration and required buprenorphine training

Prescribers must be registered with the Drug Enforcement Administration (DEA) to dispense Schedule III, IV, and V medications and must possess the special identification number for prescribing buprenorphine for opioid dependency treatment. In addition, practitioners must complete required training for treatment and management of patients with opioid use disorders from an organization the Secretary of Health and Human Services deems appropriate (examples listed include ASAM, American Academy of Addiction Psychiatry, AMA, AOA, ANCC, APA, AANP, AAPA).

Registration requirement: “Registered with the Drug Enforcement Administration (DEA) to dispense schedule III, IV, and V medications… and a special identification number for prescribing buprenorphine for opioid dependency treatment.” [[chunk 4]][[chunk 5]]
Training requirement: “Completion of required training for treatment and management of patients with opioid use disorders provided by an organization that the Secretary of Health and Human Services deems appropriate (i.e. ASAM, American Academy of Addiction Psychiatry, American Medical Association, American Osteopathic Association, American Nurses Credentialing Center, American Psychiatric Association, American Association of Nurse Practitioners, American Academy of Physician Assistants).” [[chunk 5]]

Defined terms referenced in this policy

CARA — Comprehensive Addiction and Recovery Act of 2016

Full nameComprehensive Addiction and Recovery Act of 2016 (CARA)

Role in policyEndorses use of medication‑assisted treatment (MAT) for opioid use disorder and amends the Controlled Substances Act to, under certain conditions, raise the total number of patients a prescriber can have for dispensing buprenorphine.

ContextDescribed as one of the federal laws informing prescriber authority and patient‑limit considerations in this policy.

OTP — Opioid Treatment Program

TermOpioid Treatment Program (OTP)

DefinitionProgram or qualified provider delivering opioid treatment to members with an opioid agonist treatment medication.

RelevanceDistinguishes OTP settings from office‑based treatment settings that may be covered under DATA 2000 waivers.

DATA 2000 — waiver permitting office‑based buprenorphine treatment

ActDrug Addiction Treatment Act of 2000 (DATA 2000)

DefinitionAllows qualified physicians to treat opioid dependency with FDA‑approved narcotic medications in settings other than OTPs by obtaining a waiver from certain registration requirements.

ScopePermits office‑based treatment with Schedule III, IV, and V medications or combinations of such medications when waiver conditions are met.

OUD — Opioid Use Disorder (DSM‑5 definition)

TermOpioid Use Disorder (OUD)

DSM‑5 diagnostic criteriaA diagnosis of OUD is made when at least 2 of 11 clinical criteria are met within a 12‑month period; severity ranges from mild to severe.

NoteTolerance and withdrawal are part of the diagnostic criteria generally but are not applicable to prescribed opioid use when supervised by a clinician.

SUPPORT Act — expansion of buprenorphine prescribing privileges

ActSUPPORT Act (Substance Use‑Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities)

ProvisionExtends the privilege of prescribing buprenorphine in office‑based settings to qualifying practitioners (NPs, PAs, CNSs, CRNAs, CNMs) until October 1, 2023.

Policy relevanceUsed in this policy as part of the federal legal context expanding who may prescribe buprenorphine under specified timelines and conditions.