Partial Hospitalization
Medicare Part B (Medical Insurance) may provide partial hospitalization coverage if you meet certain requirements and your doctor certifies that you would otherwise need inpatient treatment.
What is it?
Partial hospitalization provides a structured program of outpatient psychiatric services as an alternative to inpatient psychiatric care, and is more intense than care you receive in a doctor’s or therapist’s office. Treatment is provided during the day and doesn’t require an overnight stay. Medicare helps cover partial hospitalization services when they’re provided through a hospital outpatient department or community mental health center.
What are my costs?
You pay a percentage of the Medicare-approved amount for services you receive from a doctor or certain other qualified mental health professionals if your health care professional accepts assignment. You also pay coinsurance for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, including the Part B deductible.
Important notes
Medicare coverage only applies if the doctor and the program accepts assignment.
As part of your partial hospitalization program costs, Medicare may cover the following:
- Occupational therapy that’s part of your mental health treatment
- Individual patient training and education about your condition
This does not include:
- Meals
- Transportation to or from mental health care services
- Support groups that bring people together to talk and socialize. (Not group psychotherapy, which is covered.)
- Testing or training for job skills that isn’t part of your mental health treatment.
