Mobile Healthcare for People With Opioid Use Disorder

Mobile health programs can bring medical care, behavioral health services, and opioid use disorder (OUD) treatment into the same setting. Many mobile OUD programs provide mental health treatment, counseling, wound care, infectious disease testing and treatment, and ongoing primary care alongside medications for OUD (MOUD). Rosecrans et al., 2025 · Ibrahim et al., 2025

Why People With OUD Need Comprehensive Healthcare

People with OUD may also need care for depression, anxiety, chronic pain, infections, and other health conditions. SAMHSA recommends assessing medical, mental health, substance use, and social needs together. SAMHSA TIP 63

Medications remain a core part of treatment. Yet in 2022, only about one in four U.S. adults who needed OUD treatment received them. Expanding access to medication remains a priority alongside care for other health needs. Dowell et al., 2024

How Mobile Health Programs Address Medical and Behavioral Health Needs

Published studies document the services below in mobile health programs serving people with OUD and broader populations of people who use drugs or receive substance use treatment. Programs deliver care in the clinic, through telehealth, and through referral partners.

Programs already combine these services

Baltimore's Healthcare on the Spot mobile health program provides depression screening and treatment, wound care, HIV and hepatitis C services, vaccinations, and case management alongside buprenorphine. Its published model includes follow-up on laboratory results and delivery of hepatitis C medication to patients. Rosecrans et al., 2025

Boston's Community Care in Reach provides chronic disease care, immunizations, addiction treatment, and harm reduction. It refers patients for behavioral health, hepatitis C treatment, and other specialty services. These examples show the importance of specifying which services are available directly and which require a partner. Kraft Center

What the Evidence Shows About Access and Outcomes

Hepatitis C treatment in rural communities

A 2026 randomized trial enrolled 150 adults with chronic hepatitis C and current or past injection drug use in rural New Hampshire and Vermont. Treatment delivered through telemedicine in a mobile clinic increased treatment initiation to 57.3%, compared with 26.7% with referral and navigation. Documented viral clearance was 37.3% versus 18.7%. Friedmann et al., 2026

Both groups received harm reduction and navigation through the mobile health program. The trial therefore tested the addition of clinical treatment within that mobile model. Enrollment was based on hepatitis C and injection history, rather than OUD diagnosis. The findings support a specific medical service, with limits from missing follow-up and the regional sample. Friedmann et al., 2026

Treatment retention in a Baltimore mobile health program

A retrospective study of 341 patients receiving buprenorphine through Baltimore's Spot mobile health program reported 60% retention in care at 90 days. Wound care and hepatitis C treatment were associated with greater retention. The program also changed prescribing and monitoring practices. Harris et al., 2025

Published outpatient studies provide context. In Montefiore's Bronx primary care buprenorphine treatment network, 90-day retention among patients who initiated buprenorphine was 42.9% in 2019 and 68.0% in 2020, when care incorporated telehealth. A West Virginia outpatient program serving 3,255 patients from 2009 to 2019 reported 48.4% retention for at least 90 days during the first treatment episode. Cunningham et al., 2022 · Zheng et al., 2025

These figures provide context for Spot's result, although differences in patient populations, study periods, and definitions of retention limit direct comparison. The studies did not directly compare mobile and office-based care. Harris et al., 2025 · Cunningham et al., 2022 · Zheng et al., 2025

Findings from the HPTN 094 randomized trial

The HPTN 094 randomized trial compared 26 weeks of integrated mobile services plus peer navigation with navigation to community services. The analysis included 409 people without HIV who injected drugs, had OUD, and reported no MOUD treatment in the previous 30 days: 203 in the mobile group and 206 in the comparison group. Shoptaw et al., 2026

At 26 weeks, confirmed MOUD use was 14.8% versus 10.7%, and confirmed PrEP use was 5.4% versus 2.9%. Neither primary outcome differed significantly. By 52 weeks, there were 4 deaths in the mobile group and 13 in the comparison group, with an all-cause mortality hazard ratio of 0.29 (95% confidence interval, 0.1–0.9). Shoptaw et al., 2026

The mortality finding was secondary and preliminary. The trial was not powered for mortality, and service-level data could not establish which elements contributed to outcomes. Methadone was available through referral, rather than in the clinics. Shoptaw et al., 2026

How States Can Fund Comprehensive Mobile Care

New Jersey's June 2025 opioid settlement presentation identified $9.025 million over three years for mobile treatment expansion. The initiative included replacing four mobile clinics and adding three. Its service description included medical referrals, case management, and recovery support alongside medications. New Jersey DHS, 2025

Purchasing a mobile clinic and sustaining a mobile health program require separate financing plans. A 2026 review of mobile health policy describes capital investments that lacked reliable operating support after temporary funding ended. It recommends pairing grants with assistance on regulation, billing, payer contracts, and sustainability. Policy review, 2026, pp. 6, 44

Policy consideration: Grant budgets can identify the staff, clinical supplies, laboratory services, behavioral health capacity, and care coordination needed for the proposed program. Sustainability plans can distinguish reimbursable care from outreach and other activities requiring continued grant or settlement support.

Federal and State Policies That Shape the Service Model

Regulatory requirements depend on the services offered. A general mobile health program prescribing buprenorphine and an OTP providing methadone through a mobile clinic follow different federal pathways. Broader medical and behavioral healthcare also requires appropriate professional credentials and clinical capacity. CDC clinical guidance · 42 CFR 8.12

Federal authorization for medical and behavioral health services

Federal rules allow services provided by an OTP to be offered in its associated mobile clinic when there is adequate space and privacy and the program complies with applicable federal, state, and local law. SAMHSA's guidelines identify medical examinations and counseling, including telehealth, among those services. 42 CFR 8.11(h) · SAMHSA, 2024, p. 103

DEA rules allow qualifying OTPs to operate a mobile clinic without a separate DEA registration for that clinic. The parent program must obtain written approval from its local DEA office, and the clinic must operate within the same state as the registered program. 21 CFR 1301.13(e)(4)

State approval of mobile clinics operated by OTPs

In Washington, an OTP must notify the Department of Health and receive approval before providing services from a mobile clinic. North Carolina's framework adds mobile services to the parent OTP's license. Its Medicaid guidance also requires the OTP and associated mobile clinic to meet state licensing requirements. WAC 246-341-0300 · N.C. G.S. 122C-35 · NC Medicaid, 2025

Medicaid payment for medical and behavioral healthcare

Congress made the mandatory Medicaid MOUD benefit permanent in 2024. It includes FDA-approved OUD medications and associated counseling and behavioral therapies, with an exemption process for documented provider shortages. Payment for the rest of a mobile health program's care also depends on state benefits, provider qualifications, and billing rules. CMS, SMD 24-004 · Policy review, 2026

CMS identifies Place of Service 15 for mobile clinics and Place of Service 27 for qualifying street outreach to people experiencing unsheltered homelessness. POS 27 applies to locations not described by another code. These codes identify settings, while coverage and payment depend on the applicable payer rules. CMS Place of Service Code Set

State examples illustrate different payment pathways:

• Missouri: The state's May 2026 Certified Community Behavioral Health manual recognizes mobile clinics as an allowed setting. The program's services include mental health and substance use treatment, health screening, case management, and peer support. This pathway applies to qualified, enrolled providers under the state's program. Missouri MO HealthNet, 2026
• North Carolina: Effective January 1, 2025, Medicaid's OTP policy added satellite medication sites and mobile clinics as approved places of service, subject to state licensure. The update applies to Medicaid Direct and Medicaid Managed Care. NC Medicaid, 2025

Policy consideration: Clarify how mobile health programs get paid. State Medicaid officials and leaders responsible for substance use block grants and opioid response funding can review existing coverage and payment rules together. The purpose is to identify covered medical and behavioral health services, eligible billing providers, applicable billing procedures, and costs that may qualify for grant support, then give mobile health programs clear, consistent guidance.

Local Siting and Connections to Ongoing Care

Local planning, zoning, parking, and property permissions also shape service locations. California's primary care clinic guidance, for example, requires mobile clinic applicants to identify proposed service areas and obtain planning and zoning approval in each county where they will operate. Policy review, 2026, pp. 15–16 · California Department of Public Health, FAQ 35

Mobile health programs also need workable connections to services they cannot provide. The HPTN 094 protocol paired mental health screening with referrals for evaluation and treatment, and it coordinated obstetric care outside the clinic. Its navigation model included help with appointments, transportation, and records. HPTN 094 protocol, 2024

Policy consideration: Operating agreements can name the partners responsible for urgent referrals, behavioral health treatment, hospital follow-up, and specialty care. Plans can specify who follows up when a referral is missed or a test result requires action.

Technical Assistance Mobile Health Programs

State officials and funders can provide technical assistance or connect program operators with organizations that offer it. This support should help teams answer the following questions and build the skills to put their plans into practice:

• Clinical scope: Which medical and behavioral health needs will the program address directly, through telehealth, or through referral?
• Patient access: How will people receive wound care, infection treatment, or mental health support when they are not ready to start MOUD?
• Staffing and partnerships: Which licensed professionals, peers, and partner organizations are needed, and who is responsible for follow-up?
• Payment and sustainability: Which services are reimbursable, what costs remain, and what supports operations after startup funding ends?
• Evaluation: Alongside medication access and retention, will the program track wound healing, hepatitis C treatment and viral clearance, mental health follow-up, chronic disease care, and completed referrals?

About Mission Mobile Medical

Mission Mobile Medical supports healthcare organizations and public agencies in planning, implementing, and operating mobile health programs. Its services include policy analysis, financial modeling, operational planning, and mobile clinic development.

For more information, contact Mollie Williams, DrPH, MPH, Vice President of Evidence and Insights, at mollie.williams@missionmobilemed.com.