OBAT Support
To increase the access to and utilization of medications for addiction treatment (or MAT), NJ Family Care, the state’s public health care coverage program, allows for what’s called Office-Based Treatment for Addiction (or OBAT). This enables outpatient health care offices to treat patients for various substance use disorders without the patients first undergoing a behavioral health screening.
The OBAT program offers enhanced Medicaid reimbursement codes, to ensure that providers are receiving payments that match the level of services and time required to conduct an intake and ongoing care for patients. In addition to enhanced provider rates, clinics are also able to bill for navigation services such as helping address social determinants of health or making referrals to other mental health or recovery supports.
OBAT Provider Visits
Initial Intake
Code
90792 HF
Reimbursement
$460.08
Frequency of care and billing
Once per episode of care at your site​
Must be billed with an SUD Dx episode of care at your site​
Follow-up Visits
(Stabilization and Maintenance Phase)
Code
99211 HF
99212 HF
99213 HF
99214 HF
99215 HF
Reimbursement
100% Medicare rate
Frequency of care and billing
There are no longer phases for OBAT Provider visits.
Providers must complete the intake and then bill for any follow up visits as needed and appropriate. This was announced in the State Plan Amendment.
OBAT Navigator Visits
Initial Intake
(Assessment of Patient’s Needs and Creation of Psychosocial Plan of Care)
Code
H0006 HF HG
Reimbursement
$152
Frequency of care and billing
Patient must be seen same day OR within 14 days of intake visit or another provider visit.
Provider must bill within 180 days of visit.
Follow-up Visits
(Stabilization Phase)
Code
H0006 HF SU
Reimbursement
$76
Frequency of care and billing
Navigators can bill once per week for a maximum of 6 weeks during stabilization phase (does not need to be consecutive weeks) as long as the member is still being seen by the provider once per month.
Follow-up Visits
(Maintenance Phase)
Code
H0006 HF
Reimbursement
$76
Frequency of care and billing
After the six-week stabilization phase, Navigators can bill monthly during the maintenance phase as long as the member is still being seen by the provider once per month.
Can be billed 1st calendar month following final H0006 HF SU and each subsequent calendar month thereafter for as long as issues identified on the treatment plan remain unresolved.
New Jersey’s OBAT program offers patients flexibility and ease in receiving treatment, but there are requirements an office must meet before it is able to provide and bill for OBAT services. The SNJMATCOE has the following resources for providers and offices interested in initiating an OBAT service in their office.
Are you a new OBAT? Reach out to us for resources.
In addition to the tools listed above, we can also set up meetings to review key local resources, answer questions about workflows, and discuss any additional training supports your team may be interested in.