How to Become a Medicare-Enrolled OTP Supplier

How to Become a Medicare-Enrolled OTP Supplier Table of Contents How to Become a Medicare-Enrolled OTP Supplier National Government Services Provider Enrollment Call Center NGS Provider Enrollment Mailing Address [Return to Top] How [...]

Coding and Billing for OTP Services

Coding and Billing for OTP Services Table of Contents Coding and Billing for OTP Services Coding for OTP Weekly Bundles New for 2024 HCPCS Code G0137 Separate Add-on Codes Frequency of Use and Billing Billing Cycles [Return [...]

Payment Rates

Payment Rates Medicare-enrolled OTPs are paid flat dollar payment rates for the codes describing the OTP bundled services (HCPCS codes G2067 through G2080, and G2215 to G2216). Payment rates are based on the OTP provider’s geographic location. [...]

Claim Submission Instructions

Claim Submission Instructions Use the instructions on the Billing/Payment section of the CMS Opioid Treatment Program (OTP) web pages. Reviewed 9/3/2024

Billing and Payment for Dual Eligible Beneficiaries

Billing and Payment for Dual Eligible Beneficiaries A person who is eligible for both Medicare and Medicaid at the same time is “dually eligible”. Medicare is the primary payer for OTP services delivered to dually eligible beneficiaries. [...]

Psychotherapy Services

Psychotherapy Services Table of Contents Regulations and Targeted Probe and Educate Resources Medicare Regulations CMS TPE Resources NGS Resources Psychotherapy Treatment Plans Required Treatment Plan Components [...]

Psychotherapy Services

Billing Cardiac Rehabilitation Session and Session Limitations

Billing Cardiac Rehabilitation Session and Session Limitations CR sessions are limited to a maximum of two one-hour sessions per day for up to 36 sessions up to 36 weeks with the option of an additional 36 sessions over an extended [...]