What Is a Partial Hospitalization Program? - GoodRx (2024)

When weekly outpatient therapy sessions aren’t enough to manage your mental health, it’s helpful to know your options. You may hear about inpatient hospitalization for mental health conditions — when you stay overnight at the hospital.

But inpatient mental health care can be expensive. According to one report, it can cost between $3,500 and $8,500. Not to mention, hospitalization is the most restrictive type of mental health care.

Healthcare organizations have been looking at alternatives. One approach is a partial hospitalization program (PHP). This type of program may be appropriate as an alternative to an inpatient program for those who need more intensive mental health treatment.

What's a partial hospitalization program?

A partial hospitalization program (PHP) is a structured type of intensive outpatient mental health treatment program. Each program is designed to address a serious mental health issue. And it includes several different types of healthcare providers — like therapists and psychiatrists — who provide treatment.

Depending on your diagnosis, you may attend a condition-specific PHP program. For example, you may decide to admit to a trauma disorder, eating disorder, or obsessive-compulsive disorder (OCD) PHP program. Each treatment program is customized to meet the needs of the individual.

PHP programs typically last anywhere from 4 to 8 hours each day, up to 5 days a week. You commute to and from your treatment program each day. Some programs also have a telehealth option so you can participate virtually. Depending on your symptoms, you may spend weeks to several months in a PHP program.

Who are partial hospitalization programs for?

PHP programs are typically recommended for those with serious mental health conditions who need a higher level of care. This means your symptoms may not be managed or improve enough from weekly outpatient therapy sessions or meetings with a psychiatrist.

In some cases, a PHP program may be used as an alternative to an inpatient hospitalization. A PHP program may also be used as a “step-down” option after you’re released from the hospital or a residential program. This can help you gradually adjust back to your everyday life with plenty of support.

A healthcare professional must recommend a person for a PHP. If your provider decides PHP is appropriate for you, they likely recognize:

• You need a higher level of care for serious mental health concerns.

• It’s likely that you will benefit from PHP treatment.

• More intensive treatment through PHP will help you regain your regular functioning or help prevent relapse.

What are the requirements for patients in a partial hospitalization program?

Partial hospitalization programs are considered voluntary treatment. However, you will probably be asked to commit to certain requirements for admittance. For example, you may need to commit to attending every daily session on time for at least a certain number of weeks.

Once you decide what type of PHP to apply to, you need to contact the program to be admitted. A PHP representative will ask you a series of screening questions to determine if the program is appropriate based on your individual situation.

Based on your answers, a PHP provider will recommend you for the program if they believe you’re a good fit. Other factors that may determine your eligibility include:

• Having time and commitment to attend the program

• Not having active suicidal thoughts

• Needing a more structured environment and support to maintain safety

• Living in a stable residence

• Volunteering to participate in the program

What conditions do PHPs treat?

There are many types of PHP programs that can treat various conditions. A provider will often recommend a particular program based on a person’s condition.

Here are examples of conditions a PHP may treat:

• Anxiety disorders

• Obsessive-compulsive disorder (OCD)

• Bipolar disorder

• Major depression

• Eating disorders

• Post-traumatic stress disorder (PTSD)

• Substance use disorders

• Suicidal thoughts or attempts

What happens during a PHP program?

A partial hospitalization program is structured to fit your needs. You will participate in a scheduled list of treatment activities during the day and return home at night.

Those enrolled in a PHP receive different types of support to meet their needs. This often includes:

• One-on-one counseling/therapy

• Group therapy

• Skills training

• Medication management

• Educational classes

• Nursing or physical healthcare

• Care coordination

• Aftercare and relapse prevention planning

• Family therapy

• Creative therapies such as music or art therapy

Your PHP providers will give you a schedule for each day’s treatment activities. Your care team will help you design a program that meets your treatment goals.

What are the advantages of a PHP?

A partial hospitalization may provide several advantages for those with serious mental health concerns. These may include:

• Comprehensive mental health care: PHP is designed so you can access therapy, medication management, and other health services all in one place. Your treatment team works together to get you the best care for your symptoms.

• More flexibility: Since you’re not required to stay overnight with a PHP, you have more flexibility to work or attend school. Inpatient programs are more restrictive and limit the outside activities you can participate in while in the program.

• Lower costs: A partial hospitalization program is usually a less costly approach than inpatient care. Compare the daily cost for an average hospital stay in 2016 ($1,100) with the average daily costs of a PHP without insurance ($350 to $450).

These are all opportunities to help people better manage mental or health problems.

How does PHP differ from rehab?

A rehab program is typically a residential program. This means you will often live at the facility during treatment. PHP does not require you to live at a treatment center to get care.

Rehab is also specifically for substance use disorder treatment and may be your first step on the road to recovery. PHP programs can be for any mental health or substance use disorder.

The treatments and activities are similar to those of a PHP. According to the National Center for Drug Abuse Statistics, the average cost for a 3-month outpatient rehab program is roughly $5,000.

How does PHP differ from therapy?

When people refer to “therapy,” they usually mean outpatient visits to an individual provider. In therapy, you meet with your therapist once or twice a week or every other week. Each session lasts about 50 minutes. In PHP, however, you attend treatment every day for several hours. PHP is more intensive.

PHP is also different because you receive various types of treatment all in the same place. With outpatient mental health services, you may have a therapist and a psychiatrist. But you see them separately, and they’re often not affiliated with the same treatment center.

In addition to PHP, there is another type of more intensive outpatient treatment. This is referred to as an intensive outpatient program (IOP). IOP programs are generally 3 to 4 hours per day, 3 to 5 days per week.

A return to regular outpatient care may be the next step after a PHP, IOP, or inpatient care.

How much do PHPs cost?

Cost for PHPs can vary widely depending on the program and where you live. Some programs may cost $300 per day, while others charge $1,300 per day.

Some of the factors that impact the costs include:

• Length of the program

• Location of the facility

• Types of services offered

• Number of healthcare providers in the program

• Your insurance coverage and cost-sharing

Does my insurance cover PHP?

The Affordable Care Act (ACA) considers mental and behavioral health as essential health benefits. This means marketplace insurance plans must cover psychotherapy, inpatient services, and substance use disorder treatment. This also includes partial hospitalization.

However, your health insurance coverage will depend on the plan you purchase. For example, you may not get reimbursem*nt if you are out of network or choose a program that is. You may also have higher deductibles, coinsurance, and copayments.

An insurance company will often require preauthorization for a partial hospitalization program. This means you will need a letter of medical necessity. This is usually from a healthcare provider. The letter states the diagnosis, treatment, or prevention of a condition.

Medicare provides coverage for partial hospitalization. But there are certain requirements. You must get a letter of medical necessity from your healthcare provider. You must also confirm that the mental health professional you want to work with accepts Medicare.

You will receive coverage through Medicare Part B. You will pay an annual deductible and 20% coinsurance for each day. A Medicare supplement insurance policy, also known as Medigap, can help you pay for some of your out-of-pocket costs.

There is no insurance reimbursem*nt for the following:

• Job training or testing

• Meals

• Support groups for socializing

• Transportation to the care center

Co-contributor: Reneé Fabian, MA