Lexology December 15, 2023
CMS Expands Medicare Reimbursement to Cover Behavioral Health Intensive Outpatient Program Services
On Nov. 22, 2023, the Centers for Medicare and Medicaid Services (CMS) published corrections and updates to the CY 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule (the “Final Rule”) with comment period which updates Medicare reimbursement to cover Behavioral Health Intensive Outpatient (IOP) services in hospital outpatient departments, Community Mental Health Centers (CMHCs), Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Opioid Treatment Programs (OTPs) for the treatment of opioid use disorder (OUD). The Final Rule addresses physician certification requirements, coding and billing guidance, payment rates, and the scope of benefits under the expanded IOP benefit. Comments on the...
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