American Society of Addiciton Medicine

Resources and Toolkits

Practice Management

Resources and Toolkits

ASAM provides resources for its members to navigate payment issues.

AMA Prior Authorization Toolkit 

These resources from the AMA include tips to make the prior authorization process easier for physicians and staff.

AMA Toolkit for Physicians: Preparing for Implementation of the No Surprises Act” (January 2022)

Reimbursement for Medications for Addiction Treatment Toolkit

ASAM has developed a toolkit to guide addiction medicine providers on how to bill third-party payers for treating patients with substance use disorder (SUD) with medications for addiction treatment (MAT). Due to the complexity and heterogeneity of the health insurance system in the United States, this toolkit will focus on billing and payment policies established by Medicare and Medicaid, the nation’s largest payer of SUD treatment and recovery services.

This toolkit includes the following resources: 1) An overview info of MAT billing; 2) Information about state Medicaid payment policies; 3) Information about alternative payment models; and 4) Strategies to address reimbursement issues.

Credentialing, Privileges, and Enrollment

Any physician or other practitioner seeking to bill, independently, for their services must navigate credentialing, privileging, and network enrollment processes. While these three processes are often referred to as one process, they are three distinct, yet interwoven, procedures. ASAM has developed this resource to empower our members as they navigate these processes.


Third Party Payment Policy Statement

Patients who suffer from chronic medical conditions like addiction can achieve remission and sustain recovery when high quality, coordinated whole-person care is readily available and affordable. Insurance coverage for health care can make access more attainable by making it more affordable.

This policy statement addresses some of the key issues facing clinicians and third-party payers as they work together for the benefit of patients to solve the real-world practical problems of access to care, reimbursement for professional services, insurance benefit design, and health plan clinician network adequacy.

Utilization Management for Medications for Addiction Treatment Toolkit

The two most common forms of utilization management are prior authorization and fail-first policies. They can be used (1) to direct prescribers to less expensive branded or generic medications, (2) to help ensure adherence to standards of care, (3) to identify dangerous medication interactions that prescribers may miss, particularly in cases where patients are receiving medications from multiple providers, and (4) control costs.  ASAM has developed a toolkit to educate clinicians on how to navigate the various forms of utilization management that payers apply to medications for addiction treatment. The toolkit provides background information on the utilization management process, as well as analysis of the advantages and disadvantages of various prior authorization methods. 

Pharmacy Access Survey

The Pharmacy Access Survey Report uses data collected from ASAM’s Pharmacy Access Survey. This survey collected self-reported data from close to 200 respondents between February 2020 and September 2022. Respondents represent 32 different states. The implications of this survey data will be used to inform ASAM’s response to addressing pharmacy access issues and ensuring that all evidence-based medications for opioid use disorder, including buprenorphine, are readily available to those who need treatment.

Read the topline Pharmacy Access Survey Report here.

Read the full Pharmacy Access Survey Report here.