Recovery Support Services for Medicaid Beneficiaries with a Substance Use Disorder

Authors: Medicaid and CHIP Payment and Access Commission
Year: 2019
State: NatDoc: National Document
Website link:
Publicly Available: Yes
Policy: Building partnerships, General language around CHW WD, Legislative language, Lessons learned from other states
Sustainable Financing: Engaging state partners in general, General other, How to engage and work with Medicaid, Including community-based CHWs, Billing/CPT codes, Education to HC orgs on payment options bundled etc., National-level guidance, Reimbursement TA for FQHCs Medicaid etc.

Given the opioid epidemic’s considerable effect on Medicaid beneficiaries, policymakers and stakeholders have expressed interest in better understanding how states complement coverage of clinical treatment of substance use disorders (SUDs) with payment for recovery support services. Recovery support services are non-clinical services that address psychosocial factors in an individual’s environment and provide emotional and practical support to maintain remission. These services may include peer support, supportive housing, supported employment, and skills training and development. This brief begins with background on Medicaid’s role as a payer of recovery support services, including various authorities states may use to pay for these services. We then present results from our 50-state policy review including the types of providers who can be paid for providing recovery support services to Medicaid beneficiaries. Finally, we discuss opportunities to coordinate clinical treatment and recovery support services.

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