FAQ for Buprenorphine Waiver Applicants and Certified Practitioners (2024)

How do I apply for a Waiver?

To become a Buprenorphine waivered practitioner, submit anNOI buprenorphine waiver application.

The waiver application process may take up to 45 days. Check if your waiver has been approvedon theBuprenorphine Pharmacy Lookup.

If there is an urgent need for your certification, please advise us, and we will strive to expedite the approval.

I am trying to log in, but the system can’t find me. What is wrong?

Your waiver information is saved as when you first applied. You must use the same medical license number and DEA, not your X-waiver number, from your original application or it will not locate you. If you have transferred your waiver with SAMHSA, use the new DEA number. Also, use ONLY letters and numbers for your license and DEA number with no spaces; do not use punctuation.

I now have multiple DEA numbers because I work in multiple locations. How do I get another X-waiver?

The X waiver is attached to only one DEA number. A practitioner may only have one X-waiver.
The X-waiver is valid in all USA States and Territories. The practitioner may have multiple practice locations or DEA number, they may be in any US States or Territories. Therefore, if a provider already has a valid X number, they may add practice location(s) which may be in multiple States or Territories. To use your waiver with another DEA number, you must submit both the X-waiver number along with the other DEA number to prescribe. Practitioners canupdate their contact information, including adding practice locations.

If I use my x waiver in multiple locations or with different DEA numbers, what is my patient limit?

Your patient limit is cumulative, not per location or DEA number.

How may an office or pharmacy verify a waiver?

Verify certified buprenorphine providerson theBuprenorphine Pharmacy Lookup. If using your X-waiver with a different DEA number, the pharmacy must use your X-waiver number to verify, not the DEA number from another location.

I show as certified on the Buprenorphine Pharmacy Lookup; may I prescribe, or do I need to wait until I receive my waiver letter?

If you are listed on the Buprenorphine Pharmacy Lookup, then you are certified to prescribe now.

What is my X-waiver number?

Your X-waiver is your DEA number with the first letter replaced with an X. Example: DEA AB1234567 will have an X-waiver number as XB1234567.

How do I change my address or contact information?

Update your contact information, add practice locations, or opt-in or opt-out of being listed as a buprenorphine practitioner on the locator website by completing the Practitioner Contact Information form.When accessing your record use your state license number, use only letters and numbers with no spaces; do not use punctuation or your x-waiver number. Use your DEA number.

What is the difference between a 30-level waiver and a 30E-level waiver?

A 30-level waiver allows providers who wish to treat up to 30 patients to prescribe Buprenorphine. For this level waiver, physicians need 8 hours of training and APRNs or PAs need 24 hours of training.

The 30E (E for “exempt”) is an alternative that does not require training or attestation to provide counseling and other ancillary services (i.e., psychosocial services). Time spent practicing under this exemption will not qualify the practitioner for a higher patient level.

Find information on the required training.

What is required to apply directly for a 100-level waiver?

To apply directly for a 100-level waiver (without a year at the 30-patient level waiver):

Physicians must either possess additional credentialing in addiction psychiatry or addiction medicine as specified in 42 CFR 8.610(a) from the American Board of Addiction Medicine, the American Board of Medical Specialties, or the American Osteopathic Association or certification by the American Board of Addiction Medicine, or the American Society of Addiction Medicine.

OR

Physicians, APNAs or PAs must provide 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.

How do I apply for an increase to a 100- or 275-level waiver?

Apply for an increase in patient waiver limits with the NOI buprenorphine waiver application.

How do I get a new DEA Card or check my DEA Registration Status?

Call the DEA at 1-800-882-9539 or send an email to DEA.Registration.Help@usdoj.gov.

You can print a copy of your DEA certificate with the x-waiver listed. You will need to enter your last name, the business zip code you have listed on the DEA registration and your social security number.

When prompted for the expiration date of your DEA registration, you may leave the fields blank and hit login.

Will I get an approval letter/update/response by mail?

All correspondence is by email to the address you included on your application.

May physicians in residency training programs obtain DATA waivers?

Physicians in residency training can obtain a DATA waivers if their state allows unrestricted licenses and the resident obtains an individual DEA registration; hospital DEA registrations cannot be used for a DATA Waiver. You cannot use the hospital number with your personal number added to the back. The DEA number must be registered to only you.

Do I need to renew my waiver?

Practitioners at the 30- and 100-level do not need to renew their waivers. Practitioners who are at the 275-patient limit need to renew their patient limit every 3 years and submit a yearly report annually. Emergency 275E increases need to be renewed at 6 months; only one renewal is allowed. During the second 6 months, an application for a full 275-waiver should be submitted if you meet the criteria for a 275 waiver. Criteria for a 275 waiver is the same for individuals applying directly for a 100 waiver – see question 12 for more information.

Can physicians begin immediately treating patients if they have checked "Immediate" on the waiver notification form?

The "Immediate" check box is included on the form to address a provision in DATA that permits treatment while a notification is under review. Treatment in this case is limited to ONE patient per form submitted. The physician must meet the criteria for obtaining a waiver and contact the Buprenorphine Information Center at 1-866-BUP-CSAT(866-287-2728) or infobuprenorhine@samhsa.hhs.gov to verify that the notification form has been received and to notify CSAT of his/her intent to begin treating ONE patient.

Are there exceptions when approved buprenorphine products may be administered by a practitioner without the DATA 2000 waiver?

The Drug Enforcement Administration (DEA) allows prescribing without a waiver under what is known as the "three-day rule" (Title 21, Code of Federal Regulations, Part 1306.07(b)), This allows a practitioner to administer (but not prescribe) narcotic drugs to a patient for the purpose of relieving acute withdrawal symptoms while arranging for the patient’s referral for treatment, under the following conditions: 1) not more than one day’s medication may be administered or given to a patient at one time; 2) this treatment may not be carried out for more than 72 hours; and 3) this 72-hour period cannot be renewed or extended.

The intent of 21 CFR 1306.07(b) is to provide practitioner flexibility in emergency situations where he or she may be confronted with a patient undergoing withdrawal. In such emergencies, it is impractical to require practitioners to obtain a separate registration. The 72-hour exception offers an opioid dependent individual relief from experiencing acute withdrawal symptoms, while the physician arranges placement in a maintenance/detoxification treatment program. This provision was established to augment, not to circumvent, the separate registration requirement. The three-day (72-hour) emergency exception cannot be renewed or extended.

Who are the verified Training organizations and where can they be completed?

Trainings can be done online or on site. These do not expire. The current verified training organizations are:

• American Society of Addition Medicine (ASAM)
• American Academy of Addition Psychiatry (AAAP)
• American Osteopathic Association (AOA)
• American Nurses Credentialing Center (ANCC)
• American Psychiatric Association (APA)
• American Association of Nurse Practitioners (AANP)
• American Academy of Physician Assistants (AAPA)

Other training sessions.

Please reach out to the respective organization above for a copy of your training certificate to submit with your application.