To facilitate the
prescribing of naloxone , DHMH 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.
Patients who are
prescribed naloxone by their provider are not required to be
trained and certified under the ORP. However, it is important that patients are
provided information and counseling on how to recognize the symptoms of opioid
overdose and response with naloxone.
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
October 1, 2014, naloxone hydrochloride is carved-out of the HealthChoice
managed care benefit and covered by Medicaid fee-for-service (BIN 610084, PCN
RMDPROD, 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,
and $3 copay for Evizo auto-injector (requires pre-authorization). However,
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
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464