Buprenorphine Waiver Certification

To receive buprenorphine waiver certification to administer, dispense, and prescribe buprenorphine:

• Office-based practitioners must notify SAMHSA’s Center for Substance Abuse Treatment (CSAT), Division of Pharmacologic Therapies (DPT) of their intent to practice this form of medication-assisted treatment (MAT).
• The NOI must be submitted to SAMHSA before the initial dispensing or prescribing of OUD treatment medication.
• Recently published Practice Guidelines have created a training flexibility for the Notifications of Intent (NOI) to prescribe Buprenorphine.
• Find buprenorphine waivered practitioners in your local area.

In order to apply for subsequent increases in the number of clients eligible for treatment with buprenorphine:

• Office-based providers are obliged to undertake required training activities. Completion of required training accompanies the NOI.
• This pathway recognizes the importance of specialized training in managing a larger panel of patients who might require treatment with buprenorphine.
• An eligible provider may choose to undertake training, or forego it prior to prescribing buprenorphine. Those who forego training are limited to treating no more than 30 patients at any one time.

To expand access to buprenorphine, the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder exempts eligible physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives from the certification requirements related to training, counseling and other ancillary services (i.e., psychosocial services) under 21 U.S.C. § 823(g)(2)(B)(i)-(ii) of the Controlled Substances Act (CSA). Practitioners utilizing this exemption are limited to treating no more than 30 patients at any one time (time spent practicing under this exemption will not qualify the practitioner for a higher patient limit). This exemption applies only to the prescription of Schedule III, IV, and V drugs or combinations of such drugs, covered under the CSA, such as buprenorphine.

Payment Program for Rural Health Clinics Buprenorphine-Trained Providers. In June 2021, the Health Resources & Services Administration (HRSA) launched an effort to improve access to medications for opioid use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019. Approximately $1.2 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Information and registration for free waiver training is available. Please contact DATA2000WaiverPayments@hrsa.gov with any questions.

Several federal laws and regulations permit physicians and other medical personnel to administer medications approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorders (OUD) under special circumstances without a buprenorphine waiver. Learn about these special circumstances.

In addition, buprenorphine is also administered at SAMHSA-certified opioid treatment programs (OTPs). Find a SAMHSA-certified OTP in your local area.