IOP and PHP codes: which one gets the day paid
Day treatment, like IOP and PHP, bills one charge for the whole day. The catch is that the code for that day changes from one insurer to the next, and the wrong code means the day does not get paid.
For intensive outpatient, most insurers want H0015. Some psychiatric plans want S9480 instead, which commercial plans and some Medicaid plans pay, but Medicare does not. Partial hospitalization is usually S0201 on commercial plans and H0035 on Medicaid.
The form matters too. Most of these go on a facility claim, a UB-04, with a matching charge line. Some insurers want a professional claim, a CMS-1500, instead.
| Treatment | Code | Who pays it |
|---|---|---|
| Substance use IOP | H0015 | Most Medicaid and commercial plans |
| Psychiatric IOP | S9480 | Commercial and some Medicaid, not Medicare |
| Partial hospitalization, commercial | S0201 | Commercial plans |
| Partial hospitalization, Medicaid | H0035 | Medicaid plans |
Altair puts the right code and the right form on every claim, matched to what each insurer wants, so the day does not deny on a technicality, and it holds up if the insurer looks again.
Altair is the done-for-you billing service, run by AI, backed by our expert in-house billers. You do not need a billing team of your own. You treat patients. We get you paid.
Common questions
H0015 or S9480, which do I use?
H0015 is for substance use intensive outpatient, and most insurers take it. S9480 is for psychiatric intensive outpatient on commercial and some Medicaid plans, and Medicare does not pay it. We match the code to each insurer so the day gets paid.
Do IOP and PHP go on a UB-04 or a CMS-1500?
Usually a UB-04, the facility claim, with a matching charge line. Some insurers want a CMS-1500, the professional claim, instead. We bill each insurer the form it wants.
Do you handle the codes and forms?
Yes. We put the right code, charge line, and form on every claim, matched to each insurer, and check it before it goes out so it does not deny.
Sources: HCPCS and CPT codes for IOP and PHP (H0015, S9480, S0201, H0035); UB-04 facility claims; CMS and commercial insurer billing policies (2024 to 2026).