05/25/2026
Call to Action for Members: Clinicians Uniting to Raise Addiction Treatment Reimbursements
You deliver evidence-based, lifesaving care every day. Yet insurance reimbursements remain far below what’s needed to sustain quality, expand access, and retain skilled clinicians. It’s time to change that—together.
We’re uniting across NBCC, NAADAC, ASAM, NAATP, and AATOD to establish a fair, tiered reimbursement system for addiction treatment—one that recognizes quality, outcomes, and scope of care, just as in the broader medical model.
What “Tiered Reimbursement” Means for You
Fair pay for quality: Higher reimbursement for programs and clinicians meeting clear, addiction-specific quality benchmarks (e.g., timely access, retention, reduced ED use, medication adherence for OUD, culturally responsive care, integration of peers).
Transparency: Clear criteria and feedback so you know what drives higher reimbursement and how to improve.
Equity safeguards: Risk adjustment and access standards so clinicians serving higher-need populations aren’t penalized.
Why This Matters
Sustain your practice: Reimbursement that covers true costs—clinical time, supervision, care coordination, peer services, and measurement.
Improve outcomes: Incentives aligned with what works, not just visit counts.
Grow the workforce: Competitive pay helps recruit and retain counselors, physicians, nurses, peers, and supervisors.
What We’re Asking Clinicians To Do Now
Add your name: Endorse the joint statement supporting tiered reimbursement for addiction treatment.
Share your data: Contribute de-identified outcomes and access metrics (e.g., wait times, retention at 30/90 days, medication continuity) to our shared registry to strengthen the case.
Map your services: Document levels of care (outpatient, IOP, residential, withdrawal management, MOUD) and key practices (screening, MAT, contingency management, family involvement, peer support).
Tell your story: Submit brief case examples showing how current rates limit staffing, access, and continuity—and how fair tiering would change care.
Engage locally: Join your state chapter’s payer and Medicaid workgroup to push pilots and contracts that reflect this model.
What You Can Expect From Us
A clinician-friendly quality framework with specific, feasible metrics and risk adjustment.
Tools and templates: documentation checklists, outcomes tracking guides, and payer contracting language for tier differentials.
Pilot opportunities: Participate in early contracts with meaningful rate lifts tied to transparent, addiction-relevant measures.
Ongoing support: Coaching, office hours, and peer learning to help teams meet benchmarks and move up tiers.
Our Shared Goal
A payment system that pays fairly for effective addiction care—expanding access, strengthening teams, and improving outcomes in every community.
Add your voice. Endorse the statement. Join the workgroup. Let’s secure the reimbursement our patients—and our profession—deserve.