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​​Update to medical policy on maintenance treatment of opioid or alcohol use disorder​

November 1, 2022

​Effective January 1, 2023, AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey will update their medical policy on maintenance treatment of opioid or alcohol use disorder for their Commercial members.

The policy will be updated to include the Company's coverage position as follows:

  • The Company's coverage position will be updated to include methadone maintenance therapy as Medically Necessary with criteria.
  • The requirement Individual participates in a comprehensive treatment program, which includes counseling and psychosocial support will be removed under BUPRENORPHINE (PROBUPHINE®) IMPLANTS and BUPRENORPHINE (SUBLOCADETM) INJECTION.
  • The requirement Individual has shown compliance with scheduled and random urine drug screening will be removed under BUPRENORPHINE (SUBLOCADETM) INJECTION.
  • Updates to ICD-10 diagnosis codes.

For more information, please refer to the policy notification, which was published on November 1, 2022.


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