Input Data and Descriptive Details for Alternative Approaches for Office-Based Opioid Treatment With Buprenorphine
| OBOT-B With Physician-Led Visits4 | OBOT-B With Nurse-Led Visits34 | OBOT-B With Shared Visits35 | OBOT-B With Solo Provider36 | |
|---|---|---|---|---|
| Visit frequency (per patient per year), based on interviews, No. | ||||
| Initial medical evaluation (99204/G0466a) | 1 | 1 | 1 | 1 |
| Follow-up medical evaluation, Level 3 (99213/G0467) | 15 | 1 | 18 | 16 |
| Follow-up medical evaluation, Level 4 (99214/G0467) | 1 | 4 | 0 | 1 |
| Follow-up nursing visit (99211) | 0 | 13 | 1 | 0 |
| Behavioral health intake assessment (90791/G0469; combined with initial medical evaluation) | 1 | 1 | 1 | 0 |
| Group psychotherapy (90853), 12 patients per group | 19 | 19 | 18 | 0 |
| Urine drug screen (80305/G0477) | 19 | 19 | 20 | 18 |
| Staff time, based on interviews | ||||
| Physician hours (SD), per patient per year | 4.8 (1.2) | 2.0 (0.5) | 2.9 (0.7) | 5.2 (1.3) |
| Nurse care manager hours (SD), per patient per year | 1.1 (0.3) | 4.0 (1.0) | 4.0 (1.0) | |
| Behaviorist hours (SD), per patient per year | 2.4 (0.7) | 2.5 (0.8) | 3.0 (0.8) | |
| Year 1 additional physician hours (SD) | 16.0 (5.0) | 16.0 (5.0) | 16.0 (5.0) | 32.0 (10.0) |
| Year 1 nurse and behaviorist additional setup hours (SD) | 40.0 (10.0) | 40.0 (10.0) | 40.0 (10.0) | |
| Hours (SD) worked per full-time equivalent employee per year37 | 2,087.0 (96.0) | 2,087.0 (96.0) | 2,087.0 (96.0) | 2,087.0 (96.0) |
OBOT-B = office-based opioid treatment with buprenorphine.
Note: For insurance rates, we sampled from the probability distribution of Medicare payer prevalence. If a simulated individual was not selected to have Medicare, we sampled from the Medicaid prevalence. If the simulated individual was not selected to have Medicaid, we sampled from the private insurance prevalence. If the individual was not selected to have private insurance, they were assigned as self-pay/uninsured. Payment rates were log-transformed before sampling to adjust for skew and were determined from the Medicare Physician Fee Schedule Look-up Tool, publicly available state Medicaid fee schedules, and the Collective Health database of commercial payment rates.42-44 Appropriate billing codes for OBOT-B were determined in consultation with interviewed primary care practice representatives and informed by guidance from the Centers for Medicare & Medicaid Services, Substance Abuse and Mental Health Services Administration, and National Association of Community Health Centers.36-38
↵a Current Procedural Terminology (CPT) visit codes.