What is a Partial Hospitalization Program?

Not every type of rehabilitation involves having to stay 24 hours at a treatment center. In fact, there is something called a partial hospitalization program that is right for some people’s treatment needs. When it comes to learning about a partial hospitalization program, there are a few things to know. What it is, what it’s like, how it works, and what it means for insurance needs – everything you need to know about PHP vs IOP.

What Exactly is a PHP?

A partial hospitalization program or PHP is a type of hospitalization that does not require person to stay in residence or in-treatment. Instead, it is ideal for specific patients which we will address. The type of treatment a PHP is involves a structured program where a patient visits the center during the day. There, they will undergo therapy as well as groups focused on skill building and other helpful components of recovery and living sober. At night, the patient does not have to stay and can return home.

This is a program provided by the union of the American Association for Partial Hospitalization (AAPH) and the National Association of Private Psychiatric Hospitals (NAPPH). It was approved in 1988 by Congress and specifically designed for the diagnosis or active treatment of a serious mental disorder when there is a reasonable expectation for improvement or when it is necessary to maintain a patient’s functional level and prevent relapse or full hospitalization.

Who Benefits From the Partial Hospitalization Program?

While everyone benefits from therapy, this type of program is best for specific types of patients. Those who use the PHP program fall into two categories:

1. Step Down Patients. For some patients, they have finished residential treatment or an in-patient situation. This treatment may have been for mental health or substance abuse but they are at the level where a structured program meets their needs without in-patient treatment for the rest of their recovery. This allows them to better make the transition to a lifestyle that is sober and healthy.
2. Low Risk Patients. Some patients thrive in a PHP environment because they do not have the same level of needs or severity of issues s others. These patients need rehabilitation but their needs are not as severe as someone who requires 24/7 care.

There are various treatments used during a partial hospitalization program. These may include cognitive behavioral therapy or group therapy sessions. Also typical for this type of program is medication management and even family therapy.

For a person to qualify, they must not need constant care. These patients must have a stable situation where they are already living out on their own. This means that they should have a place to live, transportation, and the ability to cook or buy food since this is just a day program. In some cases, transportation may be provided but this depends on the center and their specifications. Also, it is helpful to inquire with your insurance provider because they may provide transportation to the program while you are in treatment.

How Does PHP Work?

Once you have determined with your doctor that this is the right program for you, you will need to talk to your insurance company, which we will go over further within this article.

The treatment plan itself will be something that you work out along with your therapist or doctor. You can discuss this plan and ask any questions to determine if you think it is right for you.

Once you have decided on a partial hospitalization program, it is important to keep the schedule. This schedule is a strict rule and usually lasts all day. A good example is the program running from 9 am to 3 pm. During these six example hours, you will be involved in various counseling and skills training. For example, you may have a group session, a one-on-one session, private time, and life skills training that incorporates leisure activities or things like food management.

That is just a sample but a good indicator of what to expect with a partial hospitalization program. After the day is done, you go home. These programs may last a few weeks or a few months depending on your individual needs and what your counselor thinks is appropriate.

Does Insurance Cover a Partial Hospitalization Program?

According to Medicare:

Medicare Part B (Medical Insurance) may provide partial hospitalization coverage if you meet certain requirements and your doctor certifies that you would otherwise need inpatient treatment. 

You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts Assignment. You also pay Coinsurance for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, and the Part B Deductible applies.

As far as private insurance, if your private hospitalization program is covered, you typically have a co-pay that has to be taken care of each visit. Some insurance companies, such as ComPsych Insurance, reimburse you if you have Out-of-Network Reimbursement Benefits. Of course, to find out for sure you will need to inquire with your insurance company or discuss payment options with the program’s counselor.

Is a Partial Hospitalization Program Right For You?

Only you and your therapist know if this program is right for you. Yet, if you need the needs discussed above then PHP may be ideal to help you in your recovery. To find out more about what we offer in a partial hospitalization program, check with our admissions team. Many people find that this program works well in helping them transition to a lifestyle that supports their recovery or mental health well-being.