Psychiatric Partial Hospitalization Programs

Medicare covers Psychiatric Partial Hospitalization Programs (PHPs) when a psychiatrist or trained physician certifies that a patient with an acute Axis I mental disorder requires a multidisciplinary, intensive outpatient program to avoid or replace inpatient care, the patient can actively participate, and there is a reasonable expectation of improvement. Coverage requires documented individualized treatment plans, written informed consent, appropriate physician supervision, and patient eligibility generally includes a minimum of 20 hours per week of active treatment; programs that are primarily custodial, social, recreational, or vocational are excluded.

"Admission and certification of need by a psychiatrist or physician (MD/DO) trained in the diagnosis and treatment of psychiatric illness is required for PHP coverage."

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