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Intensive Outpatient Program for Mental Health and/or Substance Use Disorder

An intensive outpatient program (IOP) for mental health or substance use disorder is a covered benefit for care that is medically and psychologically necessary and appropriate. An IOP typically consists of six to nine or more hours per week of services that include an assessment, treatment and rehabilitation for individuals requiring a lower level of care than a partial hospitalization program (PHP), inpatient/residential substance use disorder rehabilitation facility (SUDRF) care, residential treatment center (RTC) care, or acute inpatient psychiatric or substance use disorder hospitalization. 

IOPs may continue to be rendered via telemedicine when medically necessary or appropriate and within the scope of the provider’s license. These services are subject to daily limits per TRICARE policy.

Note: The Drug Enforcement Administration will allow for the prescription of controlled medications through telemedicine through Nov. 11, 2023, or through Nov. 11, 2024, if the practitioner-patient telemedicine relationship was established on or before Nov. 11, 2023.

An approval from Health Net Federal Services, LLC (HNFS) is required for all beneficiaries. The beneficiary’s primary care manager (PCM) or mental health care specialist can use our Inpatient TRICARE Service Request Notification form to submit the request. Active duty service members require a referral from their PCM or local military hospital or clinic before we can authorize IOP services.

Cost Information