Clarifying IOP billing and coding on the April NAHRI Quarterly Call

NAHRI members received association updates and learned about proper documentation, coding, and billing practices for Intensive Outpatient Program (IOP) services during the April 2024 NAHRI Quarterly Call.

Association updates

The call opened with NAHRI Director Nicole Votta providing the latest association updates.

The 2024 Revenue Integrity Symposium (RIS) will be held September 12-13 at the Hilton Chicago/Oak Brook Hills Resort & Conference Center in Oak Brook, Illinois. RIS is the premier event for revenue integrity, revenue cycle, and Medicare compliance education and networking. Attendees will learn from trusted experts with cutting-edge insights that will empower them to ensure compliance with regulatory changes, maximize revenue, enhance workflow, and improve program design.

NAHRI members receive $100 off the retail price of RIS. Register before June 10 to take advantage of our early bird discount and save an additional $100. Members looking to learn more and take advantage of additional savings can register for the pre-conference boot camp, Medicare Boot Camp®—Denials and Appeals Version, held September 10-11, and get 15% off. Special discount pricing is also available for groups.

Get a sneak peek at what we’re offering at RIS this year by signing up for our free webinar on June 19.

This year, NAHRI launched the NAHRI Scholarship program, which awards registration to RIS. Revenue cycle and revenue integrity professionals who would benefit from attending RIS but are seeking assistance with registration fees are strongly encouraged to apply. The application deadline is May 28. Learn more about the scholarship and the application process here, and apply online here. Contact NAHRI Director Nicole Votta at nicole.votta@hcpro.com for any questions about the program or applying to it.

NAHRI is currently accepting applications for an open position on its Advisory Board. Serving on the Board is an excellent way to deepen your involvement with the association, forge strong connections with your industry peers, elevate your career, and give back to the revenue integrity community. Applicants must be current NAHRI members and should be working in a revenue integrity or related role in the healthcare industry. The application deadline is May 20. Read more about applying and serving on the Board here.

2024 Revenue Integrity Week will take place June 3-7. This year’s theme is Your Career in Bloom! This event celebrates revenue integrity professionals and raises awareness of their contributions to the healthcare industry. Organizations can access the 2024 Revenue Integrity Week toolkit here to download activities, games, banners, and more. Give your outstanding colleagues the recognition they deserve during Revenue Integrity Week through NAHRI’s Peer Recognition Program.

Gather your team during Revenue Integrity Week to listen to our free webinar on June 5. Get insights on the current state of revenue integrity, best practices, and trends from a panel of revenue integrity leaders—and attendees will be eligible to earn CHRI CEUs. Register today!

IOP requirements

Following the association updates, Teri Rice, MSN, MHA, MBA, RN, CHC, regulatory instructor with HCPro, shared insights on billing and coding for IOP services.

Rice kicked off her presentation by clarifying that an IOP provides treatment at a level more intense than outpatient day treatment or psychosocial rehabilitation, but less intense than a partial hospitalization program. These services are covered by Medicare when provided by a hospital-based department, Medicare-certified community health center, rural health clinic, Federally Qualified Health Center, or opioid treatment center.

Rice detailed the criteria for IOP services and noted they are less stringent than the requirements for some other programs. She also gave examples of covered IOP services, including psychotherapy, family counseling, principal illness navigation services, and more.

Rice touched on documentation and physician supervision requirements for these services, including the initial evaluation and certification, the treatment plan, progress notes, and recertification. She also discussed billing and payment rates for hospital-based IOP services and provided helpful coding tips.

A recording of the April Quarterly Call is available for NAHRI members here. Stream more past calls here. Listening to or presenting on Quarterly Calls award 1 CHRI CEU. Register now for our 2024 series of calls. If you would like to present on an upcoming call, please contact NAHRI at  nahri@hcpro.com.