MedicaidReimbursementMedium impact
PT 75-26: Updates to Reimbursement Rates and Coverage for Long-Acting Injectable Buprenorphine for Substance Use Disorders
Maryland Medicaid·MD · Psychiatry, Family Medicine, Internal Medicine·Claims & Billing
Effective date
Mar 1, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid expanded coverage of long-acting injectable buprenorphine (Brixadi and Sublocade) to include nurse practitioners and physician assistants, and updated reimbursement rates for these substance use disorder treatments. Providers must purchase drugs directly from manufacturer and have current DEA registration to bill these codes.
Action Required
Immediately: Billing team must update system to include new reimbursement rates for buprenorphine injection codes J0577 ($420.05), J0578 ($1,680.21), Q9991/Q9992 ($1,998.53 each), and J2315 ($4.24/unit). Verify providers have current DEA registration in ePREP system. Only bill these codes when drug is purchased directly from manufacturer and administered in-office, not for pharmacy dispensing.