Key PointsQuestionWhat are US states’ prior authorization (PA) requirements for Medicaid payment for buprenorphine?FindingsThis qualitative study of 50 states’ Medicaid PA forms found that PA requirements for buprenorphine included patient surveillance with drug screenings and pill counts, behavioral health treatment recommendations or mandates, patient education, and dosing guidance.MeaningThese results suggest that PA form requirements and their associated features may contribute to the undue bureaucratic burdens that curtail access to buprenorphine for opioid use disorder.