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.

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