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    v1.0.28
    OpenPayerBilling CodesTemporary National Codes (Non-Medicare)HCPCS hcpcs-s9480-intensive-outpatient-psychiatric-services-per-diem
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    HCPCS S9480: Intensive Outpatient Psychiatric Services, Per Diem

    HCPCS Level II code S9480 describes intensive outpatient psychiatric services, per diem, representing daily billing for structured psychiatric treatment provided in an intensive outpatient program; typical service type is intensive outpatient psychiatric care delivered in an outpatient behavioral health facility or clinic where patients receive frequent, coordinated therapeutic and medical management without inpatient admission.

    For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for New Mexico Only).

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    National Reimbursement Benchmarks

    Commercial rates for HCPCS S9480 cluster around the BUCA average commercial rate of $152.60, but individual payers show sizable differences in central tendency and spread. Blue Cross Blue Shield displays the highest dispersion (P75 $231.30 minus P25 $146.00 = $85.30), indicating broader variability in negotiated rates, while Aetna is very tight (P75 $69.00 minus P25 $63.00 = $6.00). UnitedHealth Group has a moderate spread (P75 $140.50 minus P25 $32.50 = $108.00) driven by a low lower quartile and a higher upper quartile.

    Cigna’s distribution is unusually concentrated with P25, median, and P75 all at $177.90, yielding a range of $0.00, and reflects a consistent commercial price point. Blue Cross Blue Shield and UnitedHealth Group present the widest interquartile ranges, signaling the most variability in commercial contracting, whereas Aetna and Cigna show the tightest quartile bands around their central values.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 38-year-old patient with a history of recurrent major depressive disorder (F33.9) and generalized anxiety disorder (F41.1) is referred to an intensive outpatient psychiatric program after partial response to outpatient medication management and brief inpatient stabilization following a suicide risk episode. The program provides a structured, multidisciplinary day treatment schedule (typically 3–5 days per week, several hours per day) including individual psychotherapy, group psychotherapy, medication management, psychoeducation, and care coordination. A psychiatry physician (taxonomy 2084P0800X) completes initial diagnostic evaluation and medication adjustments; psychologists (103T00000X) deliver psychotherapy and psychological assessment; mental health counselors (101YM0800X) facilitate group therapy and skills training.

    Clinical workflow: on admission the patient undergoes a psychiatric diagnostic evaluation and safety assessment, an individualized treatment plan is documented, and daily attendance is recorded. Each day of attendance is billed as a per diem intensive outpatient psychiatric service using S9480. Progress notes document attendance, specific therapeutic activities (individual or group), medication management encounters, and any crisis interventions. Authorization and coverage verification are completed with payors (Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare) prior to or at admission. Discharge planning includes linkage to community outpatient services and documentation of clinical outcomes and reason for discharge.

    Related CPT Codes

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    103T00000XPsychologistA psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, a…
    101YM0800XMental Health CounselorBehavioral Health & Social Service Providers · Counselor
    2865M2000XMilitary General Acute Care HospitalA Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "fixed" facilities, primarily for DoD beneficiari…
    261QE0002XEmergency Care Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    246ZB0600XBiostatiscianNone
    261QR0400XRehabilitation Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    204F00000XTransplant Surgery PhysicianA surgeon who specializes in transplant surgery.

    Related ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    F31.9Bipolar disorder, unspecified
    F41.1Generalized anxiety disorder
    F43.10Post-traumatic stress disorder, unspecified
    F32.9Major depressive disorder, single episode, unspecified
    F33.9Major depressive disorder, recurrent, unspecified

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    10 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01
    Air ambulance transport coverage criteriaeocco2026-07-01

    Related Codes

    HCPCS-LEVEL-II-S2152-SOLID-ORGAN-TRANSPLANTATION-GLOBAL-CARE

    HCPCS Level II S2152: Solid Organ Procurement and Transplantation

    HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

    HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

    HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

    HCPCS Level II S3630: Eosinophil Count, Blood, Direct

    HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

    HCPCS Level II S4017: Incomplete Cycle — Cancelled Prior to Stimulation

    HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

    HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

    HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

    HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

    HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

    HCPCS Level II S9024: Paranasal Sinus Ultrasound

    HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

    HCPCS Level II S9366: Home Infusion TPN, 1–2 L/day

    HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

    HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

    HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

    HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

    Showing 1–10 of 532

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    CPT CodeDescriptionRelationship to This Procedure
    90834Psychotherapy, 45 minutes with patientIndividual psychotherapy sessions that may be provided within the intensive outpatient program; billed separately when documented as distinct from the per diem day services.
    90837Psychotherapy, 60 minutes with patientLonger individual psychotherapy sessions delivered during the IOP and billed separately if payor policy permits separate session billing alongside S9480.
    90853Group psychotherapyGroup therapy sessions that are core components of the intensive outpatient day; may be billed separately or included in the per diem depending on payor rules.
    90791Psychiatric diagnostic evaluationInitial diagnostic evaluation performed at program admission to establish diagnoses and treatment plan; billed separately if documented and allowed by payor when not bundled into the per diem.