Resource Center: Logistics of buprenorphine treatment, Printable form/checklist

Before starting office-based buprenorphine treatment, the following Patient Assessment Questions should be answered for each patient. Topics addressed in these questions include: Diagnosis, Medications, Drugs/Alcohol, Psychiatric and Medical Comorbidities, Psychosocial Issues, Treatment, Patient Management, and Resources.

The ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (Mee-Lee et al. 2001) lists the 5 basic levels of care available for adult substance users. These levels of care range from Early Intervention (for at-risk individuals) to Medically Managed Intensive Inpatient Treatment (for patients with severe disorders who require around-the-clock care). The Patient Placement Criteria classifies opioid maintenance therapy as a Level I treatment since it is most often conducted in outpatient settings.

PDF of Commonly Used CPT Codes in Primary Care

This form serves as a sample consent for release of the patient's information (type of information to be specified by the patient and/or doctor).