Substance Use Treatment

The following section features service utilization and medication use data of Medicaid beneficiaries in Philadelphia diagnosed in the behavioral health service system. The treatment data is provided by the Community Behavioral Health (CBH) Division of Philadelphia’s Department of Behavioral Health and Intellectual DisAbility Services.

Behavioral health services include any mental health or substance use disorder (SUD) treatment services. This includes, but is not limited to, Medications for Opioid Use Disorder (MOUD), outpatient, intensive outpatient, partial hospitalization, case management, halfway house, residential rehabilitation, and detoxification.

Residential rehabilitation services include hospital and non-hospital-based, short and long-term residential rehabilitation and specialty programs such as Journey of Hope and Women with Children. Service includes 24-hour professionally directed evaluation, care, and treatment for individuals with substance use disorder in acute or chronic distress.

Outpatient services are non-residential treatment services providing structured psychotherapy. Services can include assessments for evaluations using the American Society for Addiction Medicine (ASAM) or Pennsylvania Client Placement Criteria (PCPC), testing by a psychologist, therapy with a counselor, psychologist, or psychiatrist; individual, group, couple, or family therapy; medication administration, evaluation, or management; case management, peer support, co-occurring partial hospitalization, and collateral services. For outpatient services, regularly scheduled treatment sessions occur at least three days per week for at most five hours per week.

Medication for Opioid Use Disorder (MOUD) includes methadone maintenance (daily administration or take-home dosage), buprenorphine prescriptions, and naltrexone prescriptions. Prescription claims are provided by Physical Health Managed Care Organizations (PHMCO).

Naloxone is a lifesaving prescription medicine that reverses an opioid overdose. It temporarily blocks the effects of opioids and helps a person start breathing again.