| Dear Marci, I need to begin outpatient treatment for substance use disorder, but I am not sure where to start. Does Medicare cover treatment for substance use disorder, and how can I access these services? -Linda (Hoover, AL) Dear Linda, Yes, Medicare covers alcoholism and substance use disorder treatment if:Your provider states that the services are medically necessaryYou receive services from a Medicare-approved provider or facilityAnd, your provider sets up your plan of careExamples of these services include but are not limited to:Patient education regarding diagnosis and treatmentPsychotherapyPost-hospitalization follow-upOpioid treatment program (OTP) servicesPrescription drugs administered during a hospital stay or injected at a doctor’s officeOutpatient prescription drugs covered by Part DStructured Assessment and Brief Intervention (SBIRT) services provided in a doctor’s office or outpatient hospital. SBIRT is covered by Medicare when individual shows signs of substance use disorder or dependency. SBIRT treatment involves:Screening: Assessment to determine the severity of substance use and identify the appropriate level of treatment.Brief intervention: Engagement to provide advice, increase awareness, and motivate individual to make behavioral changes.Referral to treatment: If individual is identified as having additional treatment needs, provides them with more treatment and access to specialist care.If you are unsure where to start with your treatment, first talk to your doctor. You can speak with your doctor about substance use disorder treatments that may be best for you, and they may be able to recommend providers to you. Remember that in order for Medicare to cover your substance use disorder treatment, your provider must set up your plan of care and state that the services are medically necessary. Once you know the kinds of services you need, you can call 1-800-MEDICARE if you have Original Medicare to find behavioral health care providers and facilities in your area. You can also use the Provider Compare tool on www.medicare.gov to find mental health providers who accept Medicare payment. If you have a Medicare Advantage Plan, you can contact your plan to find mental health care providers who are in your plan’s network and to learn about any costs or restrictions associated with getting care. Finally, you can also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) at 800-662-4357 for additional help finding behavioral health care providers. SAMHSA may also be able to direct you to local resources. -Marci |