New Changes to Behavioral Health Intensive Outpatient Program Coverage in Medicare

MedicareThe Center for Health Care Strategies published a policy cheat sheet highlighting the Centers for Medicare & Medicaid Services’ coverage of intensive outpatient program (IOP) services.  As of January 1, 2024, Medicare now covers IOP services. IOPs are structured treatment programs that take place on an outpatient basis. IOPs are designed for individuals with mental health or substance use disorder (SUD) conditions, including those with co-occurring mental health and SUD conditions, who have treatment plans demonstrating a need for 9-19 hours a week of therapeutic services. The cheat sheet highlights the latest policy changes in IOP covered services, how changes impact dually eligible individuals, Medicaid-only enrollees, and new billing requirements and guidance for crossover claims.

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