Intensive Outpatient Program (IOP) Services

250 – Intensive Outpatient Program (IOP) Services (Rev. 12832; Issued: 09-12-24; Effective:01-01-24; Implementation:10-14-24) Effective January 1, 2024, section 4124 of the Consolidated Appropriations Act of 2023 (CAA, 2023) establishes Medicare coverage and payment for Intensive Outpatient Program (IOP) services for individuals with mental health needs when furnished by hospital outpatient departments, Community Mental Health Centers (CMHCs), Rural Health Clinics (RHCs), and Federally Qualified Health Centers (FQHCs). An IOP is a distinct and organized outpatient program of psychiatric services provided for individuals who have an acute mental illness, which includes, but is not limited to conditions such as depression, schizophrenia, and substance use disorders. For information regarding IOP services scope of benefits and services, certification and plan of care requirements, see Pub. 100-02, Medicare Benefit Policy Manual, chapter 6, section 70.4.