Does Medicare Cover Partial Hospitalization for Mental Health Treatments?

Medicare Part B covers partial hospitalization for mental health treatment. Partial hospitalization programs offer outpatient care in a hospital setting on a part-time basis, which can mean only during the day, only at night, or only during weekends. Partial hospitalization programs provide care that is more intensive than other forms of outpatient mental health care, but less intensive than inpatient care. In such a program, you will follow a plan of care tailored to your needs.

Services may include the following:

  • Individual or group therapy
  • Occupational therapy
  • Activity therapies, such as art, dance, or music therapy, when they are used to help you meet the goals of your plan of care
  • Prescription drugs that you cannot administer yourself
  • Training and education closely related to your plan of care
  • Family counseling that primarily supports your treatment (not if it primarily promotes the general wellbeing of the family)
  • Services needed to diagnose your condition and evaluate your care

Partial hospitalization programs may be offered by hospital outpatient departments and by community mental health centers. Medicare covers your partial hospitalization care if both of the following apply:

  • A doctor certifies that:
    • You would otherwise need inpatient treatment, or have recently been discharged from inpatient care and need partial hospitalization to avoid a relapse in your condition
    • And, less intensive treatment options (such as outpatient therapy) would not be
      enough to help you avoid hospitalization.
  • You receive care from a Medicare-certified program

Read More: Does Medicare Cover Addiction Recovery Services?
Learn About: Does Medicare Cover Prescription Drugs That Are Prescribed for Mental Health Care?
Return to: Medicare In-Depth

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