Prior Auth Required

90889 - Services-Outpatient (IOP), which may be provided in the community or during placement in residential

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceServices-Outpatient (IOP), which may be provided in the community or during placement in residential
Procedure / Service Description

Together with CCHP utilizes the MCG Guidelines to determine the medical necessity - Mental Health & Substance Abuse Partial Hospitalization Program (PHP) / day treatment. Intensive Outpatient Program H0005; H0014; H0015; H0020; H0035; H2001; H2012; H2013; H2035; H2036; Services-Outpatient (IOP), which may be provided in the community or during placement in residential S9475; S9480; 90889 treatment. Review the covered services and exclusions for further information

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.