Prepare Now: Substance Use Disorder Treatment

We announced in November what healthcare providers need to know about the updated federal rule around substance use disorder (SUD) treatment. This falls under Health Insurance Portability and Accountability Act 42 Code of Federal Regulations (CFR) Part 2 Final Rule. Providers must align with 42 CFR Part 2 Final Rule by February 16, 2026, to treat patients with SUD.

Why This Matters

Part 2 providers must use a treatment, payment, and operations (TPO) consent form to share information about patients seeking substance use disorder (SUD) treatment. Without consent and prior authorization, claims will be denied.

What to Do

Watch these videos from The Center of Excellence for Protected Health Information to confirm if you’re a part 2 provider:

• You work as a SUD provider outside a general medical facility.
• You work in a SUD unit within a general medical facility.
• You work as a SUD personnel within a general medical facility.

Use these resources for guidance:

• Review consent and patient notice templates.
• Include the TPO consent form and prior authorization with SUD treatment claims.
• Visit U.S. Department of Health and Human Services and Substance Abuse and Mental Health Services Administration for details on 42 CFR Part 2 Final Rule.

Questions? Check out our provider FAQ. Look for a final reminder in January’s Provider News.