Because methadone can only be administered by federally certified opioid treatment programs (OTP), most novel implementation efforts focus on starting individuals on methadone from other unique settings, such as during a hospitalization or incarceration, or continuing to provide stable doses of methadone from off-site medication units. The costs and logistics of implementing such programs predominantly relate to personnel costs, as starting someone on methadone requires both a clinician to determine appropriateness and dosing and someone to coordinate linkage to an outpatient OTP. When considering take-home doses, providers should discuss with patients their ability to safely store the medication. Patients should be advised that they may be able to participate in guest dosing while traveling, although advanced notice, documentation and coordination will likely be necessary. Prior to implementation, programs need to take into account workflows to accommodate regulatory requirements, billing practices, and reimbursement requirements.