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Provider Guidance

Medium

Prior to becoming a SUD Voucher provider, you must be a North Dakota Medicaid Provider.
If not currently enrolled, visit website here Medicaid Provider Enrollment

Become an enrolled SUD Voucher provider:

Medium

North Dakota licensed Substance Abuse Treatment Program

Out-of-state licensed Substance Abuse Treatment Program

 

Medium
Provider Requirements

Enrolled SUD Voucher programs must meet the following guidelines:

Individual Eligibility

To be eligible to receive services through the program, you must: 

  • Reside in North Dakota;
  • Be 14 years of age or older;
  • Have an annual income no greater than 200% of federal poverty guidelines; 
  • Lack resources to cover treatment costs or meet one of the following conditions:
    • Third-party payment resource will not cover all costs of treatment;
    • Has a pending application for medical assistance which presents a barrier to timely access to treatment; or
    • Does not qualify for medical assistance and has no alternative third-party payment resource.
Service Reimbursement Rates

*Services must meet medical necessity: an accepted health care service provided by health care entities that is appropriate to the evaluation and treatment of a disease, condition, illness, or injury and is consistent with the applicable standard of care.

Providers shall only submit one invoice per month per participant to ensure timely reimbursements can be made. Billing for services must be submitted within 180 days from when services are provided. If it is past 180 days from when services are provided, reimbursement will be forfeited.

Provider reimbursements will be paid in the PPS once per calendar month between the first and the fifth working day.

Service Rate* Specification
Screening $34.81 Per Screening
Assessment $130.28 Per Assessment
Individual Therapy $63.53 30 minutes
$84.34 45 minutes
$126.33 60 minutes
Group Therapy Adult - $311.77 Daily Rate for ASAM Level 3.5
Adolescent - $380.36
Adult - $311.77 Daily Rate for ASAM Level 2.5 (20 hours minimum per week)
Adolescent - $380.36
$217.53 Daily Rate for ASAM Level 2.1 (9 or more hours per week)
$14.50 15 minutes (1 unit) for ASAM Level 1
Family Therapy $101.93 Per Session without patient
$105.88 Per Session with patient
Room & Board (R&B) Adult - $61.45 Per service day (individual occupancy at 12:00AM
Adolescent - $74.97
Recovery Coach/ Peer Support $7.25 15 minutes (1 unit)
Urine Analysis $14.86 Limit 1 per day
Methadone Maintenance $19.46 Weekly (face to face visit two or less times)
$8.92 Daily (face to face visit three or more times
$1.00 Take home medication per day
Transportation $0.56 per mile This rate applies to dates of services prior to 7/1/21 through 9/30/21
$0.45 per mile This rate applies to dates of services on or after 10/1/21
Provider administrative costs cannot exceed individual reimbursement
Medium