Drug Testing For Opioid Treatment and Controlled Substance Monitoring

As noted in the October 2017 Medicaid Bulletin, N.C. Medicaid has drafted a new medical policy outlining the requirements and limits for drug testing for opioid treatment and chronic pain management. Effective November 1, 2017, N.C. Medicaid and N.C. Health Choice (NCHC) will cover presumptive testing up to 24 times and definitive testing up to 24 times per state fiscal year (July 1-June 30).

Testing indications and frequency of testing depend on whether the drug testing is for substance abuse or chronic pain. Due to increased confidentiality surrounding substance use disorders, drug testing limits and remaining tests available will not be posted on the NCTracks Provider Portal.

Note: Claims for urine drug testing submitted prior to November 1, 2017, will not be counted towards the limit for the current fiscal year.

For additional details regarding the new policy, refer to full article in the October 2017 Medicaid Bulletin. The new policy will be posted to the Clinical Coverage Policies webpage on November 1.