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The Climb

Eliminating Barriers to Care: X-Waiver Elimination & MAT via Telehealth

Jun 9, 2023 12:05:38 PM / by Jason Batten, LPC, ALPS, AADC

In Part I of this series, we explored the dynamic changes in the regulatory and business landscape within the behavioral health industry since the arrival of the COVID-19 pandemic. One significant obstacle to effective and accessible substance use treatment has been the presence of outdated and ineffective regulations.

In this blog, we delve deeper into the transformative regulatory adjustments impacting the substance use field. Specifically, we'll focus on the elimination of the X-Waiver and the extension of COVID-19 telehealth flexibilities, particularly in relation to virtual Medication-Assisted Treatment (MAT) and Medications for Opioid Use Disorder (MOUD) treatment.


Previously, the X-Waiver was a mandatory requirement for healthcare practitioners prescribing medications like buprenorphine to treat opioid use disorder (OUD). These practitioners had to fulfill specific educational requirements (SAMHSA, 2023) and were subject to patient limits based on their experience (ASHP, 2023). However, the recent elimination of the X-Waiver has removed these patient limits, granting prescribing practitioners greater flexibility in delivering treatment (ASHP, 2023). It's important to note that educational requirements still remain, and individual states may have additional criteria to consider (SAMHSA, 2023). These changes hold the promise of increased accessibility to buprenorphine and similar medications for those in need.

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Another big change is related to telemedicine flexibilities for prescribing medications for opioid use disorder (MOUD)/medication-assisted treatment (MAT). The Ryan Haight Act, with some exceptions, required a prescriber to conduct an in-person evaluation of a patient prior to prescribing controlled substances through telemedicine (DEA, 2023). This rule, in large part, has made it difficult to conduct 100% virtual MOUD/MAT treatment, but flexibility was allowed during the COVID-19 pandemic so that these life-saving medications could be delivered to patients 100% virtually. The DEA has extended those flexibilities from the COVID-19 pandemic through November 11, 2023. In addition, people who have established care with a provider as of the November 11, 2023 date will be permitted to continue receiving MAT/MOUD through telemedicine until November 11, 2024 (DEA, 2023). The DEA is reviewing public comments and considering potential revisions to proposed rules (DEA, 2023).


At Ascension Recovery Services, our mission is to ensure that individuals have access to high-quality and effective care for their behavioral health needs. We have established MOUD/MAT programs and various behavioral health services nationwide. One key aspect of our approach is the implementation of telehealth services, as we recognize their potential to significantly enhance access to care. Telehealth has proven to be a powerful tool, particularly during the COVID-19 pandemic, and we believe it should continue to be utilized, especially as ample evidence shows it is as beneficial as in-person services across various cases.

Take the first step towards expanding access to effective care and implementing MOUD/MAT programs by reaching out to Ascension Recovery Services today. Our dedicated team is ready to provide guidance, support, and expertise in establishing these essential programs within your organization or community. Together, we can make a difference in transforming lives and combating the challenges of behavioral health. Contact us now to explore how we can collaborate and create a lasting impact by emailing info@ascensionrs.com or by calling 304.503.3448.


ASHP. (2023, Jan 13). DEA and SAMHSA Eliminate X-Waiver Requirements. https://www.ashp.org/news/2023/01/13/dea-and-samhsa-eliminate-x-waiver-requirements?loginreturnUrl=SSOCheckOnly

DEA. (2023). Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.

SAMHSA. (2023, Jun 7). Waiver Elimination (MAT Act). https://www.samhsa.gov/medications-substance-use-disorders/waiver-elimination-mat-act

Topics: Addiction Recovery, Addiction, Recovery Services, COVID-19, Medication for Opioid Use Disorder, Medication-Assisted Treatment, telehealth

Jason Batten, LPC, ALPS, AADC

Written by Jason Batten, LPC, ALPS, AADC

Jason Batten is Ascension RS' Senior Clinical Consultant. He is a clinical mental health and substance use disorder counselor holding active licenses in several different states. He received his Master of Arts in Professional Counseling and Master of Business Administration both from Liberty University. Jason Batten has been a practicing human service professional for the past 10 years and has held several roles in various agencies ranging from Mental Health Counselor to Director of Operations. Jason Batten specializes in providing general mental health and human service support for people experiencing homelessness, serious and persistent mental illness, and substance use disorders. Most recently, Jason oversaw the clinical programs across kathy ireland® Recovery Centers’ sites.  Jason is passionate about person-centered and behavioral therapies that have proven effective with a wide range of clients. Jason believes that effective treatment helps people learn to live well and experience deep meaning and purpose in life.

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