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Alliance members impacted by the launch of the Child and Families Specialty Plan (CFSP) are invited to get more information by contacting Healthy Blue Care Together (HBCT) at 844-594-5072 or [email protected], or by contacting the NC Medicaid Ombudsman at 1-877-201-3750.

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Home / Services / Non Medicaid: Substance Abuse Intensive Outpatient Program (SAIOP)

Non Medicaid: Substance Abuse Intensive Outpatient Program (SAIOP)

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About

Coverage Information Icon

Non-Medicaid (State)

Diagnosis Group(s) Information Icon

Substance Use

Age Group(s) Information Icon

Adults 18+, Child

Reference Documents

Authorization

Submission Requirements Information Icon

  • Service Authorization Request (SAR)
  • Person Centered Plan (PCP) or Person Centered Plan (PCP) update
  • Comprehensive Clinical Assessment (CCA)

Authorization Duration and Limits Information Icon

Initial:

  • 36 units annually

Concurrent:

  • None

Minimum 3 hours/day, 3 days per week required per service definition

ASAM Level of Care Information Icon

2.1

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • H0015 – SA Intensive Outpatient Program

Full Service Definition

<a target="_blank" href="https://www.ncdhhs.gov/documents/state-funded-substance-abuse-intensive-outpatient-program-saiop-date-amendment-january-1-2026/open">Download PDF</a>
Download PDF