Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders - and of Medication for the Reversal of Opioid Overdose

Sep 21, 2026

Report detailing Medicaid coverage of medication-assisted treatment (MAT) for alcohol and opioid use disorders and Medicaid coverage of medication used to reverse opioid overdose. Includes acknowledgments and disclaimers, public domain and reproduction guidance, and recommended citation information. Provides an executive summary, background, and study methods, then presents key findings on state Medicaid reimbursement, limitations, and innovative financing and delivery approaches. Further sections address medication efficacy, cost offset and cost effectiveness, and federal and state regulations and policies affecting prescription and dispensing.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages119

Reading Time5 h 0 min

AccessFree to download

Executive Summary

Background

Study Methods

Key Findings

State Medicaid Program Reimbursement for and Limitations on MAT and Naloxone

Key Findings on Innovative Approaches to Financing and Delivering MAT

I. Introduction

II. State Considerations for Covering Medications for Alcohol and Opioid Use Disorders

A. Efficacy of Medications Used to Treat Alcohol and Opioid Use Disorders

Medications for Alcohol Use Disorders

Medications for Opioid Use Disorders

Medications for Opioid Overdose

Cost Offset and Cost Effectiveness of Medications for Alcohol and Opioid Use Disorders

Alcohol Use Disorder Costs

Opioid Use Disorder Costs

State and Federal Regulations and Policies Affecting the Prescription and Dispensing of Medications for Alcohol and Opioid Use Disorders

Federal Laws Governing Methadone and Buprenorphine

Requirements of Parity

State Laws and Policies

Professional Licensure and Certification

Facility Licensing and Certification

Billing Requirements

Data Exchange

Other Policies That May Affect Delivery of MAT

III. Medicaid Coverage of Medications for Alcohol and Opioid Use Disorders

A. Data Sources and Methodology

Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose Acknowledgments This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by IBM® Watson Health™ as subcontractor to the National Council for Behavioral Health under Contract \#HHSS283201200031I/HHSS28342002T with SAMHSA, U. S. Department of Health and Human Services (HHS) . Mitchell Berger served as the Government Project Officer and Kaitlin Abell as the Contracting Officer Representative. Disclaimer The views, opinions, and content of this publication are those of the author and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The listing of nonfederal resource is not all inclusive, and inclusion on the listing does not constitute endorsement by SAMHSA or HHS. Public Domain Notice All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authority of the Office of Communications, SAMHSA, HHS. Electronic Access and Copies of Publication This publication may be downloaded or ordered from [http://www.oas.samhsa.gov](http://www.oas.samhsa.gov. Or call)[. Or call](http://www.oas.samhsa.gov. Or call)[ ](http://www.oas.samhsa.gov. Or call)[SAMHSA at 1-877-SAMHSA-7](SAMHSA at 1-877-SAMHSA-7) ( [1-877-726-4727](1-877-726-4727)) (English and Español) . Recommended Citation Substance Abuse and Mental Health Services Administration. Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose. HHS Publication No. SMA-18-5093. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018. Originating Office Office of Policy, Planning and Innovation, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857. HHS Publication No. SMA-18-5093, 2018. HHS Publication No. SMA-18-5093. Published in 2018. Nondiscrimination Notice SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad. HHS Publication No. SMA-18-5093 Published in 2018 Table of Contents Table of Contents........................................................................................................................... iii Executive Summary ........................................................................................................................ 1 Background ................................................................................................................................. 1 Study Methods ............................................................................................................................ 1 Key Findings ............................................................................................................................... 2 State Medicaid Program Reimbursement for and Limitations on MAT and Naloxone ......... 2 Key Findings on Innovative Approaches to Financing and Delivering MAT ........................ 4 I. Introduction .......................................................................................................................... 5 II. State Considerations for Covering Medications for Alcohol and Opioid Use Disorders ... 7 A. Efficacy of Medications Used to Treat Alcohol and Opioid Use Disorders .................... 7 Medications for Alcohol Use Disorders ................................................................................. 8 Medications for Opioid Use Disorders ..

FAQs

What topics does the report cover regarding MAT under Medicaid?

It covers Medicaid coverage of medication-assisted treatment for alcohol and opioid use disorders, and Medicaid coverage of medication for reversing opioid overdoses.

What does the report include in its early sections?

It provides acknowledgments and disclaimers, public domain and reproduction guidance, recommended citation details, an executive summary, background, study methods, and key findings.

Which regulatory factors are discussed that affect prescribing and dispensing MAT-related medications?

The report discusses federal laws governing methadone and buprenorphine, parity requirements, state laws and policies, professional and facility licensure and certification, billing requirements, data exchange, and other policies influencing MAT delivery.

Sep 21, 2026

Upload by Jordan Avery