Psychiatric Partial Hospital Program Services - Medicare Advantage

Covers psychiatric partial hospitalization program (PHP) services as outpatient hospital psychiatric care for Medicare Advantage members, administered per applicable CMS National and Local Coverage Determinations (eg, LCDs L33626/L34196/L37633) and the Medicare Benefit Policy Manual (Chapter 6). Applicable to patients with mental disorders causing severe impairment who need comprehensive, medically supervised, multimodal treatment but not 24‑hour inpatient care (minimum 20 hours/week of therapeutic services); coverage is limited to services deemed medically reasonable and necessary per the MAC’s LCD and may vary by MAC jurisdiction.

"Implied covered service: psychiatric partial hospitalization program (PHP) services as an outpatient hospital psychiatric service under Medicare Part B (inferred from the document headings and cita..."

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