Apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000). To receive a waiver to practice opioid dependency treatment with approved buprenorphine medications, a practitioner must notify the SAMHSA Center for Substance Abuse Treatment (CSAT) of their intent to practice this form of medication-assisted treatment (MAT). The notification of intent must be submitted to CSAT before the initial dispensing or prescribing of opioid treatment. Qualifying practitioners can treat up to 100 patients using buprenorphine for the treatment of opioid use disorder (OUD) in the first year if they possess a waiver under 21 U.S.C. § 823(g)(2) (i.e., a DATA 2000 waiver) and meet certain requirements. Qualified practitioners include physicians, Nurse Practitioners (NPs), Physician Assistants (PAs), Clinical Nurse Specialists (CNSs), Certified Registered Nurse Anesthetist (CRNAs), and Certified Nurse-Midwifes (CNMs). Qualifying practitioners must satisfy one of the following two conditions to treat 100 patients in their first year: The physician holds a board certification in addiction medicine or addiction psychiatry by the American Board of Preventive Medicine or the American Board of Psychiatry and Neurology The practitioner provides medication-assisted treatment (MAT) in a "qualified practice setting." A qualified practice setting is a practice setting that: provides professional coverage for patient medical emergencies during hours when the practitioner's practice is closed; provides access to case-management services for patients including referral and follow-up services for programs that provide, or financially support, the provision of services such as medical, behavioral, social, housing, employment, educational, or other related services; uses health information technology systems such as electronic health records; is registered for their State prescription drug monitoring program (PDMP) where operational and in accordance with Federal and State law; and accepts third-party payment for costs in providing health services, including written billing, credit, and collection policies and procedures, or federal health benefits. After one year at the 100-patient limit, qualifying practitioners who meet the above criteria can apply to increase their patient limit to 275. In addition, 42 CFR 8.655 defines circumstances in which qualifying practitioners may request a temporary increase to treat up to 275 patients to address emergency situations. Apply for a patient waiver. Completing the Waiver Notification Form Complete the Online Request for a New Waiver or Patient Limit Increase. The NOI form contains all the data items necessary to expedite the timely processing of waiver notifications. The notification of intent must contain information on the practitioner’s qualifying credentials and additional certifications, including their capacity to refer patients for appropriate counseling and other services. It must also confirm that the practitioner will not have more than the approved number of patients at any one time for the first year, regardless of the number of practice locations. Practitioners also must upload their training certificate after completing the waiver form to show that they have completed the required training to prescribe and dispense buprenorphine. SAMHSA reviews applications within 45 days of receipt. Once the application process is complete and the application is approved, SAMHSA will email a letter that confirms the waiver and includes the practitioner’s prescribing identification number. If it has been more than 45 days since a practitioner has submitted an application or if a practitioner submitted an application and did not receive an acknowledgement of receipt, contact CSAT's Buprenorphine Information Center at 866-BUP-CSAT (866-287-2728) or send an email to email@example.com. Apply to Begin Treatment with Buprenorphine Immediately To receive permission to provide treatment while a notification is under review, check the box "New Notification, with the intent to immediately facilitate treatment of an individual (one) patient" on the notification form. Checking the “immediate” box is only one of three requirements a practitioner must meet in order to start a patient on treatment, and immediate treatment is limited to one patient per form submitted. Each form must have a different submission date. Other requirements the applicant must address, include: Meeting “in good faith” the criteria for obtaining a waiver such as having a valid medical license, valid Drug Enforcement Administration (DEA) registration, qualified, or completion of eight hours of qualifying training Contacting CSAT's Buprenorphine Information Center at 866-BUP-CSAT (866-287-2728) to verify that the notification form has been received and to notify CSAT of the practitioner’s intent to begin treating one patient Since the practitioner will not have a unique identifying number, pharmacists may question prescriptions received under this provision. Pharmacists may contact SAMHSA, if additional information is needed, at 866-BUP-CSAT (866-287-2728) or by sending an email to firstname.lastname@example.org. Training Under the Drug Addiction Treatment Act of 2000 (DATA 2000), physicians are required to complete an eight-hour training to qualify for a waiver to prescribe and dispense buprenorphine: The Providers’ Clinical Support System for Medication Assisted Treatment (PCSS-MAT) consists of a 4.25-hours webinar session and a 3.75-hours online session. For a list of trainings provided, visit the PCSS-MAT Calendar of Events. The Buprenorphine Waiver Training at the American Academy of Addiction Psychiatry covers legislation, pharmacology, safety, patient assessment, and more. Complete all the modules and pass the post-test at the end. NPs, PAs, CNSs, CRNAs, and CNMs must obtain no fewer than 24 hours of initial training addressing each of the topics in 21 U.S.C. § 823(g)(2)(G)(iv)(II)(aa); 21 USC 823(g)(2)(G)(ii)(IV)(aa)-(gg). provided by one of the following organizations: American Society of Addiction Medicine, American Academy of Addiction Psychiatry, American Medical Association, American Osteopathic Association, American Nurses Credentialing Center, American Psychiatric Association, American Association of Nurse Practitioners, American Academy of Physician Assistants, or any other organization that the Secretary of Health and Human Services determines is appropriate. NPs, PAs, CNSs, CRNAs, and CNMs may take both the eight-hour DATA-waiver course for treatment of opioid use disorder, designed by national experts, that physicians currently take, and the additional 16-hour course offered for free by SAMHSA through the Providers Clinical Support System. Learn more about buprenorphine. Disclaimer The views expressed in these courses and related materials do not necessarily reflect the official policies of the Department of Health and Human Services (HHS); nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. Acknowledgements SAMHSA-supported courses are planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through joint sponsorship with the host organizations and the SAMHSA Center for Substance Abuse Treatment (CSAT).