To facilitate the
prescribing of naloxone , MDH created a template with sample
prescriptions, which can be printed on Avery(R) 22823 Pearlized Rectangular 3x3 labels (Item:985647; Model:
22823) and affixed to
individual prescriber’s prescription pads.
There are a number of
patient counseling materials available online, including:
ORP Core Curriculum contains much of the information a patient
getnaloxonenow.org provides a free, interactive online
overdose response training
prescribetoprevent.org provides patient education, videos, and
additional overdose prevention education materials
Additional patient resources
are available here.
and caregivers should be included, when possible, in patient counseling.
If they are not available then the patient should be instructed to train
others in case of an overdose.
for Patient Counseling: According to the SAMHSA Opioid Overdose Toolkit: Information for
Prescribers, the codes for Screening, Brief Intervention, and
Referral to Treatment (SBIRT) can be used to bill time for counseling a patient
about how to recognize overdose and how to administer naloxone. Billing codes
for SBIRT include those listed below. Additional information for
prescribers can be found in the SAMHSA Toolkit.
Insurance: CPT 99408 (15 to 30 minutes)
G0396 (15 to 30 minutes)
H0050 (per 15 minutes)
Medicaid Billing and Formulary Status
Effective October 1, 2014, naloxone hydrochloride is carved-out of the HealthChoice managed care benefit and covered by Medicaid fee-for-service (BIN 610084, PCN DRMDPROD, Group ID MDMEDICAID). Claims should be processed as fee-for-service, just as claims for other carved-out drugs such as mental health drugs and antiretroviral. There is a $1 copay for generic naloxone hydrochloride (0.4mg/mL single dose vials and 2mg/2mL prefilled syringe) and NARCAN® nasal spray. The Evzio® auto-injector is not covered by Maryland Medicaid., Pharmacies may not deny service to any recipient if they are not able to pay the copay (COMAR 10.09.03.03 (M)). The durable medical equipment (DME) associated with naloxone administration has also been carved out, which includes the nasal mucosal atomizer device (MAD 300) and syringes. A list of pharmacies that are authorized to bill Medicaid for DME dispensing is available online.
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464