Bundled payments for OUD treatment services

40 - Bundled payments for OUD treatment services (Rev. 13147; Issued: 03-28-25; Effective: 01-01-25; Implementation: 03-25-25) Section 1834(w) of the Act directs the Secretary to pay to the OTP an amount that is equal to 100 percent of a bundled payment for OUD treatment services that are furnished by the OTP to an individual during an episode of care. Payment made to an OTP under the Medicare OTP benefit must be for the treatment of an opioid use disorder. The bundled payments for OUD treatment services include the medications approved by the FDA under section 505 of the FFDCA for use in the treatment of OUD; the dispensing and administration of such medication, if applicable; substance use counseling; individual and group therapy; and toxicology testing. In calculating the bundled payments, a separate payment methodology applies for the drug component (which includes the medications approved by the FDA under section 505 of the FFDCA for use in the treatment of OUD) and the non-drug component (which includes the dispensing and administration of such medications, if applicable; substance use counseling; individual and group therapy; and toxicology testing) of the bundled payments. The full bundled payment rate is calculated by combining the drug component and the non-drug components.