POS 58: Non-residential Opioid Treatment Facility
Opioid Treatment Program (OTP) — methadone clinic.
CMS description
“A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT).”
When to use POS 58
Opioid Treatment Program (OTP) — methadone clinic.
Reimbursement
Medicare OTP benefit (Part B) since 2020.
Common billing issues
- Bundled per-week MAT payment vs FFS
Frequently asked questions
What is POS 58?
Non-residential Opioid Treatment Facility. A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT).
When do I use POS 58?
Opioid Treatment Program (OTP) — methadone clinic.
How does POS 58 affect reimbursement?
Medicare OTP benefit (Part B) since 2020.
What are common POS 58 billing issues?
Bundled per-week MAT payment vs FFS.
Other POS codes
- POS 01 — PharmacyUsed primarily for vaccines administered at a pharmacy and pharmacist-rendered s
- POS 02 — Telehealth Provided Other than in Patient's HomeSince 2022, POS 02 must be used for telehealth when the patient is anywhere OTHE
- POS 03 — SchoolUsed for services provided in a school setting — typically school-based health c
- POS 04 — Homeless ShelterHealth services provided at a homeless shelter, typically by mobile clinics, str
- POS 05 — Indian Health Service Free-standing FacilityIHS billing only. Special encounter rates apply.
- POS 06 — Indian Health Service Provider-based FacilityIHS billing only, provider-based hospital outpatient setting.
Sources
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