Preparing Your Office for Opioid Treatment

Final Step

A final step should be preparing your office, including staff members, to begin office-based opioid treatment (OBOT). These tasks should include:

  • Establishing billing protocols: Decide if you will accept insurance or Medicaid coverage, run as a fee-for-service practice only, or a combination of both. Determine fees and payment plans and policies.

  • Determine your recordkeeping practices: Determine how you will store buprenorphine prescribing records, both for your own use as well as in case of a DEA site visit. Remember that these records should be stored at your DEA registered address.

  • Train staff: Both clinical and administrative staff will need to be trained on various aspects of OBOT. non-physician clinicians may benefit from taking a buprenorphine training program, even though they can not prescribe buprenorphine.

  • Assemble practice and patient education forms: There are a number of existing forms, many of which have been included in this activity, which you can use in practice. Visit our Resource Center ( to review or access all of these forms.
Related Resources: 
This clinical guidance from the PCSS-MAT provides a list of commonly used CPT codes for buprenorphine induction and maintenance. Information is includes for both psychiatrists and non-psychiatrist physicians.

Office-Based Treatment: Training Your Staff

Your staff will be assisting you with many of the tasks essential to conducting in-office buprenorphine treatment. Therefore, staff members need a firm grasp of the principles of addiction treatment and corresponding clinical skills and an attitude conducive to working with this patient population. The staff's attitudes will affect the way they treat patients, thus influencing the outcome of treatment. Before starting office-based buprenorphine treatment, you may wish to conduct formal training with your staff. The brief guidelines below can help you structure your training.

Information to Convey

In the course of your staff trainings, try to cover the following topics:

  • Addiction is a chronic medical illness, not a character flaw or weakness of will, and can be treated successfully
  • The treatment philosophy your practice espouses Substance abuse screening skills
  • Proper record keeping and compliance with confidentiality legislation
  • Appropriate interaction with patients and how to handle negative situations that may arise
  • Knowledge of other services and referral options

Principles of Staff Training

The setting and tone of the trainings and the methods of information delivery will influence learning. Keep the following principles in mind:

  • Design hands-on activities that stress experience. Focus on skills by using role-playing, for example. This will be more effective for staff than simply being lectured. Start the training with a participatory activity and intersperse these activities throughout the training to keep attention levels high.
  • Notice how the staff members learn, and try to do more things that enhance their learning.
  • Provide additional resources so that learning can continue after training is complete.

This is a training package developed by the Buprenorphine Awareness Blending Team to create awareness about buprenorphine among non-physician addiction professionals.
National Institute on Drug Abuse (NIDA) and The Addiction Technology Transfer Center (ATTC)