HealthCare News

Intensive Outpatient Program (IOP) – Clarification on Programming Hours

Issue: #408 MAY2019

Topic: Coding/Billing


Blue Cross Blue Shield of North Dakota (BCBSND) is committed to supporting members as they transition through the continuum of care for behavioral health conditions. The IOP programming hours for both psychiatric and substance use have been redefined.

IOP is a facility-based level of care and is defined as a structured, short-term treatment modality more intensive than outpatient treatment but less intensive than partial hospitalization and provided by an appropriately credentialed health care facility.

IOP is a multidisciplinary program with an individualized treatment plan delivering services of a minimum duration of three hours per treatment day. IOP treatment hours must include a minimum of three hours per week up to a maximum of 19 hours per week. IOP does not have a predetermined length of stay and does not require preauthorization.