July 2024 Issue
Want to Provide Intensive Outpatient Services to Medicare Members?
Beginning this year, any participating (contracted) Medicare-certified Opioid Treatment Program (OTP) may now be credentialed to deliver Intensive Outpatient Services (IOP) to Medicare members for Opioid Use Disorder treatment in an OTP setting
New CMS provision for IOP
As outlined in the 
Medicare Benefit Policy Manual Chapter 17 - Opioid Treatment Programs (OTPs) released by CMS, this new provision applies to facilities and agencies effective Jan. 1, 2024. The intent is to help increase access to behavioral health services for Medicare members.
IOP credentialing requirements
In addition to your current credentialing requirements as a network OTP, you must meet the following requirements to be credentialed to deliver IOP services to Medicare members:
Must have a state license for IOP and hold a valid accreditation and/or site audit or a state survey for IOP, if required by the state
Must be a Medicare-certified OTP and be listed on the CMS OTP provider site
How to get started
Simply complete the Agency Special Attestation Form. Be sure to check the box for “Medicare Intensive Outpatient (IOP) in Opioid Treatment Program (OTP),” if your program meets the requirements.
We encourage you to review our OTP-IOP Quick Reference Guide for more information. It outlines the requirements for both network and out-of-network providers, treatment guidelines and billing guidance.
Review the Guide
Questions?
If you have questions, the Network Management contract representative for your state can assist you. You may also call the Provider Services Line at 1-877-614-0484.
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Article published July 9, 2024