Substance Use Disorder (SUD) Provider Guidance

Medium

All SUD Voucher providers are required to enroll and become credentialed to bill North Dakota Medicaid.

Medium

Become an enrolled SUD Voucher provider:

Medium

North Dakota licensed Substance Abuse Treatment Program

Out-of-state licensed Substance Abuse Treatment Program

 

Medium
Medium

Additional Information

Provider Requirements

Enrolled SUD Voucher programs must meet the following guidelines:

Resources for Providers

Archived Provider Guidance Documents

Provider Reimbursement

*Services must meet medical necessity: an accepted health care service provided by health care entities that is appropriate to the evaluation and treatment of a disease, condition, illness, or injury and is consistent with the applicable standard of care.

Providers shall only submit one invoice per month per participant to ensure timely reimbursements can be made. Billing for services must be submitted within 180 days from when services are provided. If it is past 180 days from when services are provided, reimbursement will be forfeited.

Provider reimbursements will be paid in the PPS once per calendar month between the first and the fifth working day.

Medium
View Reimbursement Rates
Service Rate* Specification
Screening $35.59 Per Screening
Assessment $133.22 Per Assessment
Individual Therapy $64.96 30 minutes
$86.24 45 minutes
$129.18 60 minutes
Group Therapy Adult - $318.80 Daily Rate for ASAM Level 3.5
Adolescent - $388.94
Adult - $318.80 Daily Rate for ASAM Level 2.5 (20 hours minimum per week)
Adolescent - $388.94
$222.44 Daily Rate for ASAM Level 2.1 (9 or more hours per week)
$14.83 15 minutes (1 unit) for ASAM Level 1
Family Therapy $108.27 Per Session without patient
$104.23 Per Session with patient
Room & Board (R&B) Adult - $62.84 Per service day (individual occupancy at 12:00AM
Adolescent - $76.66
Recovery Coach/ Peer Support $7.41 15 minutes (1 unit)
Urine Analysis $15.20 Limit 1 per day
Methadone Maintenance $19.90 Weekly (face to face visit two or less times)
$9.12 Daily (face to face visit three or more times
$1.02 Take home medication per day
Transportation
$0.45 per mile Provider administrative costs cannot exceed individual reimbursement