Medications for Opioid Use Disorder (MOUD)

Posted: June 1, 2026

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Legal References

Overview

The evidence-based standard of care for opioid use disorder is MOUD. MOUD is effective as a stand-alone treatment or can be combined with education, counseling and other supportive services. MOUD includes three U.S. Food and Drug Administration (FDA)-approved medications for the treatment of opioid use disorder: methadone, naltrexone and buprenorphine. This section of the Minnesota Health Care Programs (MHCP) Provider Manual addresses the provision of these MOUDs.

Refer to Substance Use Disorder Services Opioid Treatment Programs section of the MHCP Provider Manual for information about MOUDs dispensed by an opioid treatment program (OTP).

Eligible Providers

To prescribe MOUD, MHCP-enrolled prescribers must:

· Hold a valid U.S. Drug Enforcement Administration registration that includes Schedule III prescribing authority, and

· Meet training requirements described in Section 1263 of the Consolidated Appropriations Act of 2023. Refer to Substance Abuse and Mental Health Services Administration’s (SAMHSA) Waiver Elimination (MAT Act) webpage for more information.

The following licensed provider types can prescribe naltrexone and buprenorphine:

· Psychiatric nurse practitioner

· Psychiatrist

· Physician

· Nurse practitioner

· Physician assistant

Providers do not need an X-waiver to prescribe MOUD

Section 1262 of the Consolidated Appropriations Act of 2023 (PDF) removes the federal requirement that practitioners hold a special license to prescribe medications for the treatment of opioid use disorder. The act also removes other federal requirements associated with the waiver such as discipline restrictions, patient limits, and certification related to provision of counseling. 

Eligible Members

Medications for opioid use disorder and associated services are available to MHCP members with MA and MinnesotaCare. Providers should contact the member’s Tribe or county of residence to verify specific member eligibility.

Exceptions to MOUD coverage for members include the following:

· MOUD is not covered by the Behavioral Health Fund (major program code OO) when prescribed outside of an OTP.

· MOUD is not covered by major program codes Alternative Care (AC) and Service Limited Medicare Beneficiary (SL).

· Prescribing MOUD to patients under the age of 16 is considered off-label by the FDA.

· Members enrolled through a managed care organization (MCO) should be referred to their MCO health plan for eligibility and coverage information.

Covered Services

MHCP covers related professional and facility services as well as the medications themselves.

Professional and Facility Services
Covered services related to MOUD are captured through standard evaluation and management (E/M) services including the following:

· Outpatient and other office services

· Hospital observation services

· Hospital inpatient services

· Consult services

· Critical care services

· Nursing facility services

· Emergency department services

· In addition to evaluation and management (E/M) codes, emergency department providers can also utilize G2213, an add-on code-for initiation of MOUD, which includes assessment, referral to ongoing care, and arranging access to supportive services.

Allowable Place of Service
MOUD can be prescribed, administered or dispensed as allowable by state and federal law in a variety of settings including:

· Telemedicine

· Homeless shelter

· Primary care and other office-based clinic

· Mobile medical unit

· Street medicine

· Ambulance

· Emergency department and hospital

· Urgent care

· Community mental health center

· Federally qualified health clinic

· State and local public health center

· Rural health clinic

· Campus health service

· Indian Health Services

Complementary Services
MHCP-enrolled providers may also incorporate complementary services when treating people with opioid use disorder. Some of these services include:

· Screening, Brief Intervention, Referral to Treatment (SBIRT)

· Education and counseling

· Care Coordination

· Community Health Worker services

All substance use disorder services are described on in the SUD Services section of the MHCP Provider Manual.

Covered medications

Covered MOUDs are listed on the Pharmacy Benefit Manager webpage. Go to the “Search by” dropdown list and select “PDL Class” to review the complete list of covered MOUDs. Next, go to the “PDL Class” dropdown list and enter “Opiate Dependence Treatments” and click the Search button. The search will show NDC codes, allowable amounts and prior authorization requirements for all buprenorphine formulations.

Authorization Requirements

Check the preferred drug list for prior authorization requirements for specific medications.

Legal References

Minnesota Statutes, 152 – Drugs; Controlled Substances
Minnesota Statutes, 152.11 – Prescriptions
Minnesota Statutes, 152.12 – Health Care Providers May Prescribe
Code of Federal Regulations, title 42, section 12.3
Consolidated Appropriations Act of 2023 (PDF), section 1262