Partial Hospitalization & Intensive Outpatient Programs

Partial Hospitalization Program (PHP) & Intensive Outpatient Program (IOP)

Partial hospitalization provides a structured program of outpatient psychiatric services as an alternative to inpatient psychiatric care. It’s more intense than care you get in a doctor’s or therapist’s office. This treatment is provided during the day and doesn’t require an overnight stay. Medical insurance and Medicare helps cover partial hospitalization services when they’re provided through a hospital outpatient department or community mental health center. Along with your partial hospitalization program, your medical insurance company may cover occupational therapy that’s part of your mental health treatment and/or individual patient training and education about your condition.

Medicare only covers partial hospitalization if the doctor and the partial hospitalization program accept assignment.

 

Intensive Outpatient Program (IOP)

An intensive outpatient program (IOP) is a freestanding or hospital-based program that maintains hours of service for at least 3 hours per day, 2 or more days per week. It may be used as an initial point of entry into care, as a step up from routine outpatient services, or as a step down from acute inpatient, residential care or a partial hospital program. An IOP can be used to treat mental health conditions or can specialize in the treatment of co-occurring mental health and substance use disorders. When supported by the benefit plan, coverage may be available for intensive outpatient programs that are provided with less intensity to members who are recovering from severe and persistent mental health conditions.