Intensive Outpatient Program
Since November 1, 2024, providers have been able to enroll with Wisconsin Medicaid as intensive outpatient program (IOP) providers. For more details, visit the Intensive Outpatient Program service area of the ForwardHealth Online Handbook.
Intensive Outpatient Program Trainings
ForwardHealth Updates
The most recent ForwardHealth Updates are listed below.
ForwardHealth Update 2024-38, “New Intensive Outpatient Program Benefit” (10/22/2024)
Adult Mental Health Day Treatment Providers, Community Health Centers, Community Support Programs, Crisis Intervention Providers, HealthCheck Other Services Providers, Hospital Providers, Outpatient Mental Health Clinics, Outpatient Substance Abuse Clinics, Rural Health Clinics, Substance Abuse Day Treatment Providers, Tribal Federally Qualified Heath Clinics, HMOs and Other Managed Care Programs
This Update informed providers of the new IOP benefit, including policies for eligible providers, enrollment, covered and noncovered services, prior authorization (PA), reimbursement, claims submission, member information, and available training for providers that provide IOP services.
Supplemental Materials
Providers are required to document specific information. The materials below meet these documentation requirements. The table below indicates which materials are recommended for use and which materials are required. Providers can search for forms by entering the form number in the Keyword or Form Number field on the Forms page of the ForwardHealth Portal (the Portal)
Prior Authorization/Intensive Outpatient Treatment Attachment (PA/IOP), F-03325 (02/2025)
Form for requesting authorization of IOP services (mental health services and/or substance use treatment)
Required
Prior Authorization Request Form (PA/RF), F-11018 (05/2013)
Form for requesting authorization of covered services
ForwardHealth Online Handbook Intensive Outpatient Program Service Area
The following ForwardHealth Online Handbook topics and resources include key content for IOP services.
Note: The topics highlighted on this page are linked to address some of the most common provider questions. This is not a complete list of all Online Handbook topics for providers. Providers are still responsible for reviewing the full Intensive Outpatient Program service area of the Online Handbook for complete IOP policy.
Provider Enrollment and Ongoing Responsibilities
Categories of Enrollment, #3969
Online Handbook Topic
Guidance for enrolling as a Wisconsin Medicaid provider
Examples of Ongoing Responsibilities, #216
Responsibilities of providers
1099 Miscellaneous Forms, #6277
Documentation requirements of providers
A Comprehensive Overview of Provider Rights, #208
Rights of providers
Intermediate Sanctions, #211
Possible consequences for violating program rules and regulations
Provider Identification, #3421
National Provider Identifier requirements
Claim Submission
Accuracy of Claims, #516
Provider responsibility to submit accurate, truthful, and complete claims
1500 Health Insurance Claim Form Completion Instructions, #17797
Provider requirements and instructions for submitting Wisconsin Medicaid and BadgerCare Plus claims
Uploading Claim Attachments Via the Portal, #11677
Guidance on attaching and submitting records with claims
Claim Status, #535
Process for checking the status or adjusting a claim
Explanation of Benefit Codes in the Claim Header and in the Detail Lines, #4822
Messages from ForwardHealth about the status or action taken on a claim, claim detail, adjustment, or adjustment detail
Electronic (Claim Adjustments), #512
Requirements and process for submitting claim adjustments electronically
Options for Electronic Claims Submission
Provider Trainings
Multiple training modules for submitting claims electronically
ForwardHealth Provider Portal Professional Claims User Guide
User Guide
How to submit professional claims electronically
ForwardHealth Portal Uploading Claim Attachments Instruction Sheet
Instruction Sheet
Step-by-step guide for attaching claim records
Covered and Noncovered Services
Prior Authorization
Additional Resources
Because you have not recently performed an action that loads or reloads a page, your session will expire in Upon expiration your unsaved data will be lost and you will be required to login again to begin a new session. To avoid a session expiration, click this button to extend your session.
Extend