Apple Health (Medicaid) Drug Coverage Criteria
- Clinical Guidelines and Coverage Limitations for Medication Assisted Treatment (MAT)
- Prescribing Medication Assisted Treatment (MAT)
- Request for Buprenorphine Monotherapy (13-330)
- Request for IM Naltrexone (13-331)
- Request for Buprenorphine/Naloxone over 24mg Per Day (13-332)
- Patient Status (13-333)
Note: For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates web page.