New Guidance on Billing Requirements for Intensive Outpatient Program Services for Federally Qualified Health Centers & Rural Health Clinics

Starting January 1, 2024, Medicare began coverage and payment for Intensive Outpatient Program (IOP) services that Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) provide for people with mental health needs. An IOP is a distinct and organized outpatient program of psychiatric services provided for patients with acute mental illness including, but not limited to, conditions such as depression, schizophrenia, and substance use disorder. The Centers for Medicare & Medicaid Services (CMS) will pay for IOP services provided at the same payment rate as those paid to hospitals. Additional information on IOP services including scope of benefits, certification and plan of care requirements, payment policies, and coding and billing requirements is included in the recent CMS guidance.

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