OTP: Opioid Treatment Program
OTPs are SAMHSA-certified, DEA-registered, and state-licensed programs that dispense methadone (and may also offer buprenorphine and naltrexone) for opioid use disorder. The only setting in which methadone may be dispensed for OUD.
How OTPs are regulated
OTPs operate under 42 CFR Part 8 and state licensure. Patients receive medication on-site under observed dosing initially, with eligibility for take-home doses based on time in treatment, clinical stability, and behavioral indicators. SAMHSA modernized take-home rules in 2024 to expand patient autonomy and address access barriers.
OTP billing — Medicare bundled rate
Medicare reimburses OTPs through a bundled weekly rate that covers medication, counseling, and other services (HCPCS G2067-G2080 series). Most state Medicaid programs follow a similar bundle. Add-on codes apply for specific services like initiation evaluations or take-home extensions.
OTP analytics priorities
- Treatment retention at 6 and 12 months.
- Take-home eligibility tracking and time-to-take-home progression.
- Counseling encounter compliance for bundled rate.
- Co-occurring conditions (BH and medical) tracking for whole-person care.
Where Vizier fits
Vizier supports the SAMHSA-required reporting + billing analytics OTPs need. The 42 CFR Part 2 access controls apply: SUD treatment data is segregated and audit-logged with stricter access than general PHI.