State-administered Medicaid will expand its coverage of residential substance abuse recovery starting
Feb. 1, Wisconsin Department of Health and Human Services officials announced Friday.
The state has offered coverage for certain types of recovery programs since 2017, according to the
release. That coverage, provided through the Comprehensive Community Services program, focused on
treatment on programs offered in facilities with 16 or fewer beds.
The expanded coverage allows for treatment in facilities with more beds, which account for more than
65 percent of the available recovery beds in Wisconsin, according to the release.
Treatment costs, including assessment and treatment planning, counseling, medication management,
case management, peer support and recovery coaching are covered under the newly expanded services.
Medication-assisted treatment is also covered under the expansion, according to the release.
Treatment options for opioid dependence can include buprenorphine, methadone, and naltrexone. It
also offers coverage for acamprosate, disulfiram, and naltrexone to treat alcohol dependency disorder.
The program also covers naloxone for opioid overdose prevention, according to the U.S. Substance
Abuse and Mental Health Services Administration.
The expansion does not cover room and board in residential treatment facilities, nor does it cover
non-treatment residential settings, such as sober living homes, recovery residences, or community living
arrangements.
“The services offered under this benefit are critical to providing the most appropriate level of care for
many of those dealing with severe and long-term addictions,” according to Wisconsin Medicaid Director
Jim Jones.
Officials can offer the expansion after obtaining a waiver from the federal Centers for Medicare and
Medicaid Services, according to the release. Anyone looking for substance use treatment and recovery services can call the Wisconsin Addiction Recovery Helpline (hyperlink) at 211. The helpline is free, confidential, and available 24/7
