Psychiatric Inpatient Hospitalization

Medicare covers inpatient psychiatric hospitalization when a beneficiary requires 24-hour medical supervision and "active treatment" under an individualized physician‑supervised plan because they cannot be safely or adequately managed at a lower level of care. Coverage requires physician certification/recertification, documentation of active treatment and failure or inability to be treated in outpatient settings, licensed providers delivering psychotherapy per state scope, and excludes primarily custodial, recreational, or maintenance-only services and several specifically named noncovered therapies.

"Medicare beneficiaries requiring 24-hour-per-day medical supervision and coordination for a mental disorder are eligible for inpatient psychiatric hospitalization in a certified psychiatric hospita..."

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