HCPCS Code H0015: Alcohol and/or Drug Services; Intensive Outpatient Program (IOP)

Get paid for every claim. Our guide to HCPCS H0015 covers documentation, billing, and modifiers for intensive outpatient programs.

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Frequently asked questions

Medicare pays for IOP in the hospital and CMHC settings when program and documentation standards are met, and when claims are submitted with the required elements such as condition code 92 and appropriate revenue codes. Medicare Advantage plans follow plan policy and may require authorization and additional documentation.

Mental health IOP is a structured program operating at least three hours per day for at least three days per week, using multiple modalities such as individual therapy, group counseling sessions, family work, skills training, and medication management. It bridges care between traditional outpatient services and partial hospitalization programs within broader mental health services.

There is no single CPT code that universally represents an IOP day. Payers typically use billing codes like H0015 for SUD IOP or S9480 for psychiatric IOP per diem days, while some require a combination of time-based CPT/HCPCS lines for the services billed within a day.