CDPHP
CDPHP Coverage for Addiction Treatment in Albany, NY
Don’t let insurance questions get in the way of recovery. At Fusion Recovery in Albany, NY, our admissions team will verify your CDPHP benefits, explain what’s covered in plain language, and help you start treatment, often the same day.
START HEALING TODAY
Personalized Outpatient Treatment for the Capital Region
At Fusion Recovery, we understand the weight that addiction places on your life and the lives of those you love. That’s why we offer personalized outpatient addiction treatment built around your specific situation, your goals, your schedule, and your recovery needs.
As an outpatient rehab serving Albany, NY, and the broader Capital Region, we provide flexible scheduling so you can stay engaged with work, family, and other commitments while getting the help you deserve. Our team blends evidence-based therapies with medication-assisted treatment, clinical counseling, and holistic support to help you build a recovery that lasts.
If you or someone you love is struggling, contact us today. Our admissions team will verify your CDPHP benefits, walk you through your treatment options, and help you take the next step at no cost and with no pressure.
ABOUT CDPHP
Albany's Hometown Health Plan
CDPHP, Capital District Physicians’ Health Plan, is one of the most recognized names in Albany healthcare, and for good reason. Founded in 1984 by a group of Capital District physicians, CDPHP began as a not-for-profit, physician-guided HMO headquartered right here in Albany. More than 40 years later, CDPHP continues to serve members across 24 New York counties throughout the Capital Region, Hudson Valley, Mohawk Valley, and beyond, with a network of more than 10,000 providers.
CDPHP offers a full spectrum of plan types, including HMO, PPO, EPO, Medicare Advantage, Medicaid managed care, and Child Health Plus, giving Albany-area residents flexible options for coverage. The plan has placed a particular emphasis on behavioral health and medical integration, recognizing that mental health and substance use treatment are inseparable from overall health.
Under the Mental Health Parity and Addiction Equity Act and New York State Insurance Law, CDPHP plans must cover mental health and substance use treatment at the same level as physical health services. New York State Insurance Law also adds further protections, including up to 28 days of inpatient substance use treatment at NY OASAS-licensed facilities for members with a primary substance use disorder diagnosis.
OVERVIEW OF CDPHP BENEFITS
What CDPHP Covers at Fusion Recovery
Coverage details vary by plan and product line, but most CDPHP plans cover a comprehensive range of addiction treatment services at Fusion Recovery.
Treatment services that are partially or fully covered
- Medical detox and supervised withdrawal management
- Outpatient rehab and intensive outpatient programs (IOP)
- Partial hospitalization programs (PHP)
- Individual, group, and family therapy
- Medication-assisted treatment (MAT), including Sublocade and Suboxone
- Dual diagnosis care for co-occurring mental health conditions
- Aftercare planning and continued outpatient support
Coverage details
Out-of-pocket costs, including copays, coinsurance, and your deductible, depend on your specific CDPHP plan, whether you’re enrolled in a commercial HMO, EPO, PPO, Medicare Advantage, Medicaid managed care, or Child Health Plus product. Our admissions team will verify your benefits and explain exactly what to expect before you start treatment.
Preauthorization and level-of-care reviews
Some CDPHP plans require prior authorization for medical detox, partial hospitalization, or intensive outpatient programs. For substance use disorder care in New York, CDPHP uses LOCADTR 3.0, the Level of Care for Alcohol and Drug Treatment Referral tool developed by NYS OASAS and Columbia University, to determine the appropriate level of care. Fusion Recovery’s admissions team handles authorizations and continued-stay reviews on your behalf so treatment isn’t delayed.
Call Now to Verify Your Coverage
HOW IT WORKS
How to Verify Your CDPHP Benefits
Verification is fast, free, and fully confidential. Here’s how it works:
01.
Share your details
Call us at 1.866.936.2290 or fill out our contact form with your CDPHP member ID and group number.
02.
We verify your benefits
Our team contacts CDPHP directly to confirm in-network status, deductibles, copays, prior authorization requirements, and what level of care is covered under your plan.
03.
We explain your options
We walk you through your benefits in plain language, outline any out-of-pocket costs, and recommend the level of care that fits your needs.
04.
You take the next step
When you’re ready, we schedule your clinical assessment and help you begin treatment, often the same day.
WHAT WE TREAT
Conditions We Treat at Fusion Recovery
Our Albany, NY treatment programs serve adults struggling with a wide range of substance use and co-occurring mental health conditions, including:
- Alcohol use disorder
- Opiate and prescription painkiller addiction
- Heroin addiction
- Fentanyl addiction
- Cocaine addiction
- Methamphetamine addiction
- Benzodiazepine dependence
- Co-occurring depression, anxiety, PTSD, and other mental health conditions
Ready to Take the First Step?
Recovery begins when you reach out. Our admissions team is available to verify your CDPHP coverage, answer your questions, and help you start treatment in Albany, NY. Call anytime, we’re here when you’re ready.
Frequently Asked Questions
01. Is Fusion Recovery in-network with CDPHP?
Fusion Recovery may be in-network with CDPHP plans serving Albany, NY and the Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
03. What does CDPHP cover for addiction treatment?
CDPHP plans typically cover the full continuum of substance use treatment, including medical detox, intensive outpatient programs (IOP), partial hospitalization (PHP), standard outpatient care, individual and group therapy, medication-assisted treatment, dual diagnosis care, and aftercare. Specific coverage depends on your plan and product line.
05. How long will CDPHP cover inpatient treatment in New York?
Under New York State Insurance Law, CDPHP plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage past 28 days is reviewed using LOCADTR 3.0 based on your progress and ongoing clinical need.
07. Will I have to pay anything out of pocket?
Out-of-pocket costs depend on your specific CDPHP plan, your deductible, and any copays or coinsurance under your policy. Members on Medicaid managed care plans typically have minimal cost-sharing, capped at $200 per calendar year under New York Medicaid rules. Our admissions team will give you a clear picture of expected costs before treatment begins.
09. Will my employer or family find out I'm seeking treatment?
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and CDPHP cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
02. Is CDPHP a local Albany insurance plan?
Yes. CDPHP is one of the most distinctly local health plans in the country. It was founded in Albany in 1984 by a group of Capital District physicians and remains headquartered in the area, now operating from its Wellness Way campus in Latham, NY. CDPHP serves members across 24 New York counties, with deep roots in the Capital Region.
04. Does CDPHP cover MAT medications like Suboxone and Sublocade?
Yes. CDPHP plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. CDPHP has been a vocal supporter of MAT, even partnering with local primary care physicians through initiatives like Courage to Care to expand access to opioid use disorder treatment in the Capital Region.
06. Does CDPHP cover Medicaid managed care or Medicare?
Yes. CDPHP offers Medicaid managed care plans, Medicare Advantage plans, Child Health Plus, and the Essential Plan in addition to commercial HMO, EPO, and PPO products. Each product line covers substance use treatment, though specific cost-sharing and authorization rules can vary.
08. Do I need a referral from my primary care doctor?
Some CDPHP HMO plans require a referral from your PCP for specialty services, while EPO and PPO products typically don’t. Our admissions team will check the requirements for your specific plan during the verification process and help obtain any referrals or prior authorizations needed.
10. What if CDPHP denies coverage for my treatment?
Don’t give up. CDPHP plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
01. Is Fusion Recovery in-network with CDPHP?
Fusion Recovery may be in-network with CDPHP plans serving Albany, NY and the Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
02. Is CDPHP a local Albany insurance plan?
Yes. CDPHP is one of the most distinctly local health plans in the country. It was founded in Albany in 1984 by a group of Capital District physicians and remains headquartered in the area, now operating from its Wellness Way campus in Latham, NY. CDPHP serves members across 24 New York counties, with deep roots in the Capital Region.
03. What does CDPHP cover for addiction treatment?
CDPHP plans typically cover the full continuum of substance use treatment, including medical detox, intensive outpatient programs (IOP), partial hospitalization (PHP), standard outpatient care, individual and group therapy, medication-assisted treatment, dual diagnosis care, and aftercare. Specific coverage depends on your plan and product line.
04. Does CDPHP cover MAT medications like Suboxone and Sublocade?
Yes. CDPHP plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. CDPHP has been a vocal supporter of MAT, even partnering with local primary care physicians through initiatives like Courage to Care to expand access to opioid use disorder treatment in the Capital Region.
05. How long will CDPHP cover inpatient treatment in New York?
Under New York State Insurance Law, CDPHP plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage past 28 days is reviewed using LOCADTR 3.0 based on your progress and ongoing clinical need.
06. Does CDPHP cover Medicaid managed care or Medicare?
Yes. CDPHP offers Medicaid managed care plans, Medicare Advantage plans, Child Health Plus, and the Essential Plan in addition to commercial HMO, EPO, and PPO products. Each product line covers substance use treatment, though specific cost-sharing and authorization rules can vary.
07. Will I have to pay anything out of pocket?
Out-of-pocket costs depend on your specific CDPHP plan, your deductible, and any copays or coinsurance under your policy. Members on Medicaid managed care plans typically have minimal cost-sharing, capped at $200 per calendar year under New York Medicaid rules. Our admissions team will give you a clear picture of expected costs before treatment begins.
08. Do I need a referral from my primary care doctor?
Some CDPHP HMO plans require a referral from your PCP for specialty services, while EPO and PPO products typically don’t. Our admissions team will check the requirements for your specific plan during the verification process and help obtain any referrals or prior authorizations needed.
09. Will my employer or family find out I'm seeking treatment?
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and CDPHP cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
10. What if CDPHP denies coverage for my treatment?
Don’t give up. CDPHP plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan's Evidence of Coverage or Summary Plan Description for full details. Treatment services must be medically necessary to be covered. Any treatment decisions must be discussed with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate information regarding your benefits.
Take the first step
Providing hope to all. Compassionate outpatient care for our community. Ready to talk?
Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.
David Sietz, M.D.
Chief Medical Officer, Fusion Recovery
Email us or Call
Contact Form
"(Required)" indicates required fields
Start Healing Today
At Fusion Recovery, we understand the difficulties that addiction can bring into your life. That’s why we offer personalized outpatient addiction treatment tailored to your unique needs. As an outpatient rehab facility, we provide flexible scheduling so you can continue your work, family life, and other commitments while getting the help you deserve.
Fusion Recovery proudly accepts CDPHP coverage for addiction treatment services including outpatient rehab, therapy, medication-assisted treatment, and more. Our compassionate team of experts will verify your CDPHP benefits, take care of claims, and make insurance processes smooth. More importantly, we’ll craft an individualized treatment plan using evidence-based therapies and holistic methods to facilitate your lifelong recovery.
With Fusion Recovery, you can find judgment-free support and healing in a comfortable environment. Our welcoming facility and amenities create a peaceful space for you to focus on your recovery journey. If you or a loved one is struggling with addiction, contact us today to learn more about CDPHP coverage and how we can help you get your life back.
Overview of CDPHP Benefits
Fusion Recovery is in-network with CDPHP plans.
Treatment services covered
CDPHP covers services like outpatient rehab, individual therapy, group therapy, medication management, and aftercare support. Our team can help verify your coverage and explain your options before starting treatment so you know what to expect.
Coverage details
Coverage details vary by individual CDPHP plan. Out-of-pocket costs such as copays, deductibles, and coverage levels depend on your specific benefits. Our team can help verify your coverage and explain your options before starting treatment.
Preauthorization requirements
Prior authorization may be required for medication-assisted treatment and intensive outpatient programs. Fusion Recovery can assist with obtaining authorizations.
CALL NOW
Safe and Effective
Verify Your Insurance Coverage.
Remember, the specifics of coverage can vary based on your individual plan and location. It’s always a good idea to confirm coverage with both your insurance provider and Fusion Recovery.
What We Treat
Alcohol Treatment
Alcohol is widely available, which can make harmful patterns harder to spot early.
Heroin Treatment
Heroin is a fast-acting opioid that can quickly reshape the brain and body.
Fentanyl Treatment
Fentanyl is a potent synthetic opioid linked to high overdose risk, even at small amounts.
Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan’s Evidence of Coverage or Summary Plan Description for the full details and specifics of your benefits. Treatment services must be medically necessary to be covered by your health plan. Whether a treatment or service is medically necessary will be determined based on a review of clinical information provided by your provider. Any treatment decisions must be discussed and determined in conjunction with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate and up-to-date information regarding your benefits and coverage for addiction treatment services.
Take the first step
Providing hope to all. Compassionate outpatient care for our community. Ready to talk?
Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.
David Sietz, M.D.
Chief Medical Officer, Fusion Recovery
Email us or Call
Contact Form
"(Required)" indicates required fields
