The report from the Centers for Medicare & Medicaid Services (CMS) outlines state-level policy that can reduce barriers to using telehealth for treating substance use disorders (SUDs) among pediatric Medicaid populations. Medicaid coverage and state laws regarding telehealth vary by state, so this report highlights how delivering care to children with SUD differs between telehealth and in-person visits in terms of costs and quality of care. While the field is still emerging, there are promising practices that could improve access to care where options for SUD treatment is limited.