Medicaid Behavioral Health Services: Injectable Buprenorphine for Medication Assisted Treatment (MAT)

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 45; No - 0; NR - 6	Yes - 13	Yes - 15
Alabama	Yes	Yes - not specified	No
Alaska	Yes	NR	NR
Arizona	Yes	NR	Prior authorization for non-preferred drug
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	Yes	$3	No
Connecticut	Yes	No	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Prior authorization is required when prescribed over the FDA approved maximum amount
Florida	Yes	No	Sublocade Soler Syringe is limited to 300 mg every 30 days
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	Yes	No	NR
Indiana	Yes	No	Prior authorization is required for buprenorphine extended-release (Sublocade)
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	Yes - not specified	Prior authorization is required
Maine	Yes	No	Yes - not specified
Maryland	Yes	$1 for generic and $3 for brand name, If the drug is administered as a part of a larger visit, there's no cost sharing	No
Massachusetts	Yes	Yes - not specified	One time per month
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	$3 office based opioid treatment	Prior authorization is required when provided in an Opioid Treatment Program as a weekly bundled code including medication.
Missouri	Yes	Yes - not specified	No
Montana	Yes	No	Prior authorization is required
Nebraska	Yes	No	No
Nevada	Yes	No	No
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	$4	NR
North Dakota	Yes	No	No
Ohio	Yes	No	NR
Oklahoma	Yes	No	NR
Oregon	Yes	No	No
Pennsylvania	Yes	$1 for generic prescriptions, $3 for brand-name	No
Rhode Island	Yes	No	Yes - not specified
South Carolina	Yes	No	NR
South Dakota	Yes	$1 pharmacy copay for generic and $3.30 for brand-name	No
Tennessee	Yes	No	No
Texas	Yes	No	Yes, Not Specified
Utah	NR	NR	NR
Vermont	Yes	Usually administered in provider's office without a member copay. With pharmacy claims the member would pay $1, $2 or $3, depending on the cost of the drug.	Prior authorization is required; quantity limit of maximum 30-day supply
Virginia	Yes	No	Service authorization is required
Washington	Yes	No	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	$1 generic, $3 brand for drugs billed under the pharmacy benefit	NR
Wyoming	Yes	$0.65 generic, $3.65 brand	More than 16 mg buprenorphine per day requires a prior authorization

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Medicaid Behavioral Health Services: Injectable Buprenorphine for Medication Assisted Treatment (MAT)

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Medicaid Behavioral Health Services: Injectable Buprenorphine for Medication Assisted Treatment (MAT)

2022

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