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However, CMS continues to defer to SAMHSA guidance on the use of audio-only telecommunications for initiation of treatment with methadone pursuant to 8.12(f)(2)(v)(A), which allows a specific exception to allow for the use of audio-only devices when the patient is in the presence of a licensed practitioner who is registered to prescribe (including dispense) controlled medications, and when audio-visual technologies are not available or their use is not feasible for a patient (89 FR 7539)