Due to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), mental health and substance use disorder treatments are largely covered by insurance. CBT-OUD is generally covered by both Medicare and Medicaid. The challenge is that CBT-OUD counselors - particularly those with specialized training and/or a doctoral degree - often do not accept public insurance, which means that services are typically offered out of network.