US · guidance
CMS Pub. 100-04, ch. 4, § 261.6
Payment for Intensive Outpatient Program Services
Beginning with services provided on or after January 1, 2024, the A/B MAC (A) makes
payment for hospital outpatient departments under the hospital outpatient prospective
payment system for intensive outpatient program services. The Part B deductible and
coinsurance apply.
For CAHs, payment is made on a 101% reasonable cost basis.
In CY 2024, payment for non-excepted off-campus hospital-based IOPs will be made
under the MPFS, paying the CMHC per diem rate for APC 5851, for providing up to 3
IOP services per day and APC 5852, for providing 4 or more IOP services per day.
The Part B deductible, if any, and coinsurance apply.
History
(Rev. 12423; Issued: 12-20-23; Effective: 01-01-24; Implementation: 01-02-24)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e78743702a83e1a8e2cf3b06f6178cbc921a40284b65274bb1a0fb5ac21930e0
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