Medicaid Methadone Clinic Reimbursement


Medicaid covers a variety of medications for use in the treatment of substance use disorders. This page features cost report and reimbursement information for Medicaid methadone clinics. Connecticut State Plan Amendment (SPA) No. 18-016 was approved on June 21, 2018 with an effective date of February 1, 2018. This SPA amends Attachment 4.19-B of the Medicaid State Plan in order to make various changes to the reimbursement of chemical maintenance clinics including: pro-rating the weekly rate to account for weeks in which services are provided on fewer than seven days in the week, specifying in detail the services that are included in the rate, and providing for specific types of documentation regarding the services that are provided. The SPA also removes references to specific provider locations, establishes provisions for merged clinics and newly licensed clinics, and authorizes payment for take-home doses in compliance with federal guidelines Medicaid Provider Bulletin regarding billing and payment can be found at the HUSKY Health website. State of Connecticut regulations regarding payment of Behavioral Health Clinic Services can be found at Connecticut eRegulation.

Connecticut State Plan Amendment (SPA) 19-014 - Clarifying language that border providers who are licensed chemical maintenance clinics in an area bordering Connecticut are eligible for payment on the same conditions as newly established in-state chemical maintenance clinics. 

OMB Circular A-87 establishes principles and standards to provide a uniform approach for determining costs and to promote effective program delivery, efficiency, and better relationships between governmental units and the Federal Government. The principles are for determining allowable costs only.

Annual Cost Report Submission
Cost reports will be submitted to the Department annually and no later than 180-days after the end of the provider's fiscal year. If a provider fails to submit a complete and accurate cost report on or before the deadline, the Department will notify the provider and the provider has thirty days from the date the notice to submit a complete and accurate cost report. The commissioner may reduce the applicable rate for chemical maintenance services for a provider that fails to submit a complete and accurate cost report by an amount not to exceed ten percent (10%) of such rate. Please submit cost report questions to:

New cost reports have been developed to assist providers in completion of the annual submission. Please download the new cost report and guidance below. Providers are welcome to participate in webinar sessions to assist in understanding and completion of the new cost report design. 

Cost Report Guidelines  (November 2020)

Cost Report  (November 2020)