Office-based Buprenorphine Treatment
Buprenorphine Enhanced Medication Assisted Recovery and Treatment (BESMART) Program
BESMART was developed in 2019 to be a specialized provider network focused on contracting with high quality medication assisted treatment (MAT) providers to provide comprehensive care to TennCare members with opioid use disorder (OUD).
- Must be a TennCare provider.
- Must have a specific contract with each Managed Care Organization (MCO) for BESMART.
- Must complete the BESMART attestation, attesting to the BESMART program description.
Not yet a TennCare provider? Visit Provider Registration to learn more.
BESMART Program Description
Note: The program description content is the same for all MCOs.
The following are benefits for providers in the BESMART program:
- Clinical and care coordination support from MCOs
- Increased data on quality and health outcomes
- Enhanced reimbursement from the MCOs for defined BESMART services
- Access to monoproduct buprenorphine
- Shortened Prior Authorization Form
Buprenorphine Prior Authorization Form
Note: The Prior Authorization Form can be submitted via fax or electronically. It cannot be submitted over the phone.
Please contact OptumRx with questions or feedback.
OptumRx Call Center
Phone: 1-866-434-5524
- Members can access increased buprenorphine treatment dosage options through BESMART providers
TennCare members who receive OUD treatment by a BESMART Provider will be eligible to receive buprenorphine product coverage with the following daily dosage limits:
- Up to 16mg of buprenorphine products per day throughout induction, stabilization, and maintenance phases as medically necessary
- If specific clinical criteria are met, may receive a maximum daily dosage of 24mg of buprenorphine products for the defined length of time established in in the clinical criteria
Deep Dive: 16 mg buprenorphine
BESMART Provider
- Follow best practice guidelines about tapering down or off treatment
- Follow best practice guidelines about utilizing lowest effective dose of Medication Assisted Treatment (MAT)
- Attest to the requirements of the BESMART Program Description
TennCare Member
- Members can receive up to 16 mg buprenorphine containing products daily
Deep Dive: 24 mg buprenorphine
BESMART Provider
- Can prescribe maximum daily dosage of 24 mg of buprenorphine for specific populations
- Cannot exceed one year in duration for 24 mg
Eligible TennCare Member Populations
- Pregnant participants confirmed by provider attestation
- Postpartum participants for a period of 12 months from delivery date as shown by medical records or insurance claim
- Recent intravenous drug users confirmed by prescriber attestation and a positive urine drug screen
- Current users receiving greater than 50mg of methadone for OUD treatment transitioning to buprenorphine agonist therapy
- Current users of 16mg-24mg per day of buprenorphine demonstrated by paid claims data from the participants previous health insurer
The following describe the steps to become a BESMART provider:
- Understand the program description and evaluate your current care model
BESMART Program Description
Note: The program description content is the same for all MCOs.
BlueCare BESMART program description
Amerigroup BESMART program description
UnitedHealthcare program description
- Identify any potential gaps or areas for increased support from MCOs
- Obtain a Medicaid Provider ID (if needed)
- Indicate interest in joining BESMART and ability to meet program standard
BESMART Provider Interest Form
Complete the BESMART Provider Interest Form.
- Contract as a BESMART provider with appropriate MCO(s) to join network
- Continue to provide high-quality MAT care to TennCare members
As outlined in Public Chapter Nos. 761 and 771, Nurse Practitioners (NPs) and Physician Assistants (PAs) must participate in at least one MCO’s network of BESMART providers in order to be reimbursed for the prescription of buprenorphine.
To be eligible to contract with TennCare as a BESMART Provider, a NP or PA must also meet the following criteria:
- Contracted in the BESMART Program
- Has a supervising physician that is contract within the MCO’s BESMART Program
- Specializes in family, adult, or psychiatric medicine
- Part of an Office-based Opioid Treatment center (OBOT), Community Mental Health Center (CMHC), or Federally Qualified Health Center (FQHC)
- Holds an X-DEA number and TennCare Medicaid ID
- Follows member limits according to the legislation
NP & PA Prescribing Guidance Webinar (August 2020)
For contracting questions:
- Amerigroup: renea.bentley@amerigroup.com or brittany.greene@amerigroup.com
- BlueCare: MAT_Referral_CM_UM@bcbst.com
- UnitedHealthcare: SE_Government_Programs@uhc.com
For prescribing questions:
- OptumRx: TNRxEducation@optum.com
Referral Information for Outpatient Mental Health & Substance Use Disorder Treatment and Services and Treatment for Complex Cases
TennCare Managed Care Organization (MCO) Provider Directory Links
Provider Directory/Provider Portal
Tips for searching for a community mental health center:
- Click the Provider Portal link above.
- Select Location and Plan.
- Click Places by Type and enter Community Mental Health Center.
Tips for searching for an outpatient substance use disorder provider:
- Repeat the first two steps above
- Click Doctors by specialty and enter Outpatient Substance Abuse Treatment Services.
Tips for searching for a community mental health center:
- Click the Find a Doctor link above.
- Change All Networks to BlueCare.
- To narrow the search, enter your City, State and Zip Code.
- Search for Behavioral Health Facility.
Tips for searching for an outpatient substance use disorder provider:
- Repeat the four steps above.
- Click the More Filters option and select Expertise.
Select the appropriate category from the drop-down list.
Tips for searching for a community mental health center:
- Click on liveandworkwell.com.
- Enter city/location.
- From left menu, select Coverage/Plan Type > Medicaid.
- Search Community Mental Health Center.
Tips for searching for an outpatient substance use disorder provider:
- Repeat the first three steps above.
- Search Outpatient Substance Use Disorder.
Are you concerned that your patients need:
- Medication-Assisted Treatment (MAT)
- Assistance with behavioral health appointments/resources
- Assistance with scheduling a follow-up appointment with a primary care provider
- Additional information about their health care benefits
- Advocacy and assistance in finding health care specialists
- MCO-level case management because they are chronically ill
TennCare’s (Buprenorphine Enhanced Supportive Medication Assisted Recovery and Treatment ) BESMART Network Provider Referral Information
Tips for searching for a Medication Assisted Treatment Provider:
- Click the Provider Portal link above.
- Select Location and Plan.
- Click Doctors by specialty and enter Medication Assisted Treatment.
For referrals to the Behavioral Health Case Management Team:
- Contact Provider Services at 1-800-454-3730.
- Follow prompts and select Case Management.
Tips for searching for a Medication Assisted Treatment Provider:
- Choose BlueCare Network.
- Enter your location.
- Choose Medication-Assisted Treatment.
- You may need to expand the distance to 50 miles for some remote areas.
- Doctors have limited waivers and availability will fluctuate, so providing multiple options is possible.
MAT Provider Referral Line:
800-814-8936
Tips for searching for a MAT provider:
- Click Search for a Provider.
- Click Behavioral Health Directory.
- Choose Plan and Location.
- Enter Medication Assisted Treatment.
Provider Services:
- Call 800-690-1606.
- Say “yes” if you are a provider.
- State reason for calling (e.g., find a provider for referral).
- Enter the member’s identification number.
TennCare Managed Care Organization Contacts for Complex Cases
Note: Use this information if your patients have challenging medical and behavioral health conditions and you need additional assistance locating an inpatient or outpatient provider.
If you need help scheduling an outpatient appointment for a patient with complex medical or behavioral health needs, please contact the member’s TennCare MCO.
TennCare Provider Referral Information
Monday – Friday 8 a.m. – 5 p.m.
Susan Hinson RN CCM
Emergency Department/BH Team Lead
901-232-6716
Outside of Business Hours:
Amerigroup ED Referral Voice Mailbox for Case Management
615-882-8212
Email referrals to case management: AGPBehavioralHealthRef@amerigroup.com
Provider Services:
800-690-1606
Email referrals to case management: tn_case_management@uhc.com
Inpatient Assistance:
If you need assistance with discharge planning, contact your assigned UHC Utilization Nurse and they can refer you to a Discharge Care Manager.
Member Contact Information
Member Services:
800-600-4441
Amerigroup On Call 24/7:
866-864-2544
BlueCare Member Services:
800-468-9698
Member Services:
800-690-1606
April 2021: BESMART Programmatic Updates
- BESMART Buprenorphine Dosage Changes [Webinar Slides]
- BESMART Buprenorphine Dosage Changes [Full Recording]
August 2020: NP & PA Prescribing Guidance
December 2018: MAT Webinar Series
- Buprenorphine MAT Network: Program Updates [Webinar Slides]
- Buprenorphine MAT Network: Program Updates [Webinar Recording]