Payment

The cost of buprenorphine can vary depending on the dose. Cost of a dose of buprenorphine is determined by:

  • The pharmaceutical company, brand names and other companies that produce generic buprenorphine
  • The health plan
  • Retail pharmacies

Daily doses are normally from 8 mg to 24 mg (if using sublingual tablets), (Sullivan & Fiellin, 2008).

View ReferencesHide References
Blueshift Research. Camurus and Indivior Set to Significantly Sway the Opioid Abuse Treatment Market . Blueshift Research Report. 2017. Accessed on: 2017-03-21.
Sullivan, L, Fiellin, D. Narrative Review: Buprenorphine for Opioid-Dependent Patients in Office Practice. Annals of Internal Medicine. 2008; 148(9): 662-670. Available at: http://www.intnsa.org/resources/publications/position_june_2012.pdf Accessed on: 2015-12-04.
Related Resources: 
Description: 
This pie chart shows the breakdown of how buprenorphine patients paid for their doctor's visits. 204 patients in NAABT's physician-patient matching system were surveyed.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Description: 
This study examines decision-making in the buprenorphine treatment distribution and payment systems. The study is based on interviews with health care leaders involved in the distribution and adoption of buprenorphine.
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The Center for Substance Abuse Treatment (CSAT)
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CoverageBuprenorphine treatment costs are typically not covered by Medicare unless the treatment is provided in an inpatient or outpatient treatment center. It may also be covered in some instances, such as during detoxification or early stage stabilization. However, the Medicare benefit does not usually cover typical office-based buprenorphine induction or maintenance treatment visits.

Related Resources: 
Description: 
This website offers comprehensive guidelines for treating patients who have substance use disorders.
Source: 
American Psychiatric Association (APA), 2006
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Physician stage in practice: 
Description: 
Displays the appropriate CPT and HCPCS billing codes for the different phases of buprenorphine treatment.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Description: 
This is a database that allows users to search Medicare Prescription Coverage and Medicare Advantage Prescription Drug Plans by State.
Source: 
Department of Health and Human Services
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Description: 
This database allows physicians to search for local Medicare policies and relevant articles.
Source: 
US Department of Health and Human Services
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Description: 
This is the web format of a special addiction program by HBO. The material covers issues such as who pays for addiction treatment, and drug treatment for adolescents.
Source: 
Home Box Office, Inc., 2007
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Cash Only TreatmentSome providers run a cash-only buprenorphine treatment practice in which they set their own fees and costs for treatment. Cash-only-service treatment providers should have a clear policy and cost sheet regarding initial and ongoing expenses for treatment. This should include costs for assessment, induction, and maintenance visits.

Related Resources: 
Description: 
This website is designed to support physicians who prescribe buprenorphine by linking them up with a national network of trained physician mentors.
Source: 
Physician Clinical Support System (PCSS)
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Tags: 
Description: 
This chapter of the TIP 45 discusses funding, resources, organization and patient contracts in substance abuse treatment.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
This newsletter article from NAABT.org lists and describes 15 ways patients can save money on buprenorphine treatment.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Patient Handouts: 
Description: 
Displays the appropriate CPT and HCPCS billing codes for the different phases of buprenorphine treatment.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Description: 
This is an article written by CIGNA Behavioral Health's (CBH) Senior Medical Director. It describes how CIGNA addressed reimbursement, a major barrier to physician prescription of buprenorphine, by identifying an HCPCS code (H0033) that physicians can use to bill for the services provided during buprenorphine induction visits.
Source: 
Nemecek, Doug. Behavioral Healthcare: November 2007.
field_vote: 
Resource Type: 
Description: 
This study examines decision-making in the buprenorphine treatment distribution and payment systems. The study is based on interviews with health care leaders involved in the distribution and adoption of buprenorphine.
Source: 
The Center for Substance Abuse Treatment (CSAT)
field_vote: 
Resource Type: 
Description: 
This pie chart shows the breakdown of how buprenorphine patients paid for their doctor's visits. 204 patients in NAABT's physician-patient matching system were surveyed.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
field_vote: 
Description: 
This is the web format of a special addiction program by HBO. The material covers issues such as who pays for addiction treatment, and drug treatment for adolescents.
Source: 
Home Box Office, Inc., 2007
field_vote: 
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