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Medicare PHP

Medicare PHP Coverage

The most intensive care Medicare covers without an overnight admission is partial hospitalization: structured days, psychiatric oversight, daily group work, then home each evening. Programs listed here record day treatment together with Medicare acceptance, hospital-based departments and freestanding sites alike.

Hospital outpatient departments and community behavioral health organizations both deliver this, and your share of the cost can differ depending on which one bills the claim. Ask how many hours a day runs and how discharge gets planned. Compare a few before deciding.

Rehab Centers Near You

Top 12 Drug and Alcohol Rehab Centers That Accept Medicare PHP

Clear Steps Recovery – Needham

392 Chestnut Street, Needham, Massachusetts, 2492

5.0★★★★★92

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicareAccepts TRICARE+4

Co-occurring DisordersMATTrauma-informed+9

392 Chestnut Street in Needham puts Clear Steps Recovery inside a short drive of Dover, Wellesley and the towns around them. Wellesley, Dedham, Newton and Brookline all sit within 6 miles of the door. Needham sits in Norfolk County, and the county's own provision is limited enough that this site draws from a wide area. Care offered spans partial hospitalization, intensive outpatient and outpatient care. SAMHSA holds the federal registration; the Massachusetts Bureau of Substance…

4.1 miHarvey Beach13 miBoston Logan International AirportServes61 towns

Substances treated

Adderall Rehab · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Chronic Pain and Substance Use · Codeine Rehab · +37 more

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Online Rehab and Telehealth · Outpatient MAT Clinic · +6 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Community Reinforcement Approach · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · +8 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · +5 more

Groups served

Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military PTSD Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Telehealth · Active Duty Military Trauma Rehab · Active Duty Military TRICARE Rehab · Adult Rehab · +70 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intervention Services · Practical Support · Recovery Support Services · Self Help Groups · +3 more

Insurance accepted

Harvard Pilgrim Health Care · Mass General Brigham Health Plan · Medicare · Optum · TRICARE · Tufts Health Plan · UnitedHealthcare (UHC) · VA Community Care

Ocean State Recovery Center – Johnston

1524 Atwood Avenue, Johnston, RI 02919

4.9★★★★★~~365~~

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicaidAccepts Medicare+5

Co-occurring DisordersMATTrauma-informed+9

Spanish spoken

Ocean State Recovery Center operates from 1524 Atwood Avenue in Johnston. The site sits in Providence County, which shapes which public funding routes apply. Nearby communities include Cranston and Greenville. Rhode Island draws people across long distances for treatment, so travel time is worth weighing against waiting time. Partial hospitalization, intensive outpatient and outpatient care are delivered here, alongside medication-assisted treatment, telehealth appointments and care for co-occurring mental health conditions. Which level fits depends on…

3.6 miSlacks Pond Beach8.1 miRhode Island T. F. Green International AirportServes35 towns

Substances treated

Levels of care

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Community Reinforcement Approach · Contingency Management · Counseling and Therapy · Couples Counseling · +10 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Illness Management and Recovery · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · +4 more

Groups served

Support services

Case Management · Chronic Illness Management · Community Outreach · Education and Job Training · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intensive Case Management · +12 more

Languages

Spanish Speaking Rehab

Insurance accepted

Medicaid · Medicare · TRICARE

Coastal Detox Inc – Stuart

1131 SE Indian Street, Stuart, FL, 34997

4.8★★★★★~~290~~

Joint Commission

DetoxHospital detoxInpatient+5

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATMethadone+10

Spanish spoken

The address on record is 1131 SE Indian Street in Stuart, Florida. It is recorded as offering residential treatment, partial hospitalization and intensive outpatient. This is recorded as treating co-occurring conditions rather than one in isolation. Care runs on site, with accommodation included for the duration. Family involvement is listed as part of the provision. Federal registration is held through SAMHSA, and licensing sits with the Florida Department of Children and Families.

3.0 miSouth Fork Saint Lucie River34 miPresident Donald J. Trump International AirportServes7 towns

Substances treated

Adderall Rehab · Alcohol Detox · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Ativan (Lorazepam) Rehab · Beer Addiction Treatment · Benzodiazepine Rehab · Binge Drinking Treatment · Carfentanil Rehab · +53 more

Levels of care

14-Day Rehab · 21-Day Rehab · 30-Day Rehab · Addiction Retreat · Aftercare and Continuing Care · Alcohol Detox Program · Anxiety Retreat · Ativan (Lorazepam) Detox Program · Benzodiazepine Detox Program · Buprenorphine-Assisted Detox · +61 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · +8 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training · +1 more

Groups served

Active Duty Military Detox · Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Trauma Rehab · Active Duty Military TRICARE Rehab · Adult Rehab · Couples Rehab · +78 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · HIV Treatment · Housing and Employment Support · Housing Assistance · Nutrition and Fitness Counseling · Peer Support · Practical Support · +5 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · AmeriHealth · Avmed · CarePlus Health Plans · Cigna Healthcare · ComPsych · Emblem Health · First Health · Golden Rule Insurance Company · +10 more

Detox5 photos

Bayview Recovery Center

2515 Camino del Rio S suite 300, San Diego, CA 92108, United States

5.0★★★★★~~152~~

Joint Commission

DetoxPHPIOP+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+1

Co-occurring DisordersSeniorsMen+1

Bayview Recovery Center provides specialized substance use and mental health treatment services designed to meet the unique needs of men in Southern California. Located in San Diego, the center emphasizes a clinical, evidence-based approach to recovery, integrating medical care with psychological support to address the root causes of addiction. The facility maintains accreditation from The Joint Commission, reflecting its commitment to high-quality healthcare standards and patient safety. Since its establishment, Bayview Recovery Center has offered…

4.4 miSan Diego River3.9 miSan Diego International AirportServes13 towns

Substances treated

Adderall Rehab · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · Dexedrine Rehab · Fentanyl Patch (Duragesic) Rehab · Fentanyl Rehab · Heroin Rehab · Hydrocodone Rehab · Hydromorphone (Dilaudid) Rehab · +22 more

Levels of care

Aftercare and Continuing Care · Detox Centers · Evening Treatment · Intensive Outpatient Program (IOP) · Medical Detox · Non-12-Step Rehab · Outpatient Rehab · Partial Hospitalization Program (PHP) · Recurrence Prevention · Rehab Transfers · +1 more

Therapies

Counseling and Therapy · Evidence-Based Therapy · Individual Therapy

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Mental Health Treatment

Groups served

Men's Dual Diagnosis Rehab · Men's Outpatient Rehab · Men's Rehab · Senior Detox · Senior IOP · Senior MAT · Senior Outpatient Rehab · Senior PHP · Senior Rehab

Insurance accepted

Aetna · Anthem / Elevance Health · Blue Shield of California · Cigna Healthcare · Covered California · Kaiser Permanente · Medicare · TRICARE · TriWest Healthcare Alliance · UnitedHealthcare (UHC) · +1 more

Comprehensive Wellness Centers – Lake Worth

660 South Dixie Highway, Lake Worth, FL, 33462

4.8★★★★★~~201~~

Joint Commission

DetoxInpatientResidential+6

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersMATTrauma-informed+8

Spanish spoken

The provider's premises are at 660 South Dixie Highway, Lake Worth, Florida. Provision here is recorded as residential treatment, partial hospitalization, intensive outpatient and sober living. Provision spans substance use and mental health together. This is residential provision, so someone lives at the facility throughout. Remote appointments appear on the record, useful where travel is difficult. Group and family work are both recorded. Both federal registration through SAMHSA and Florida Department of Children and Families…

1.3 miSouth Palm Beach7.7 miPresident Donald J. Trump International AirportServes10 towns

Substances treated

Adderall Rehab · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Chronic Pain and Substance Use · Codeine Rehab · Concerta Rehab · +37 more

Levels of care

14-Day Rehab · 21-Day Rehab · 30-Day Rehab · 45-Day Rehab · 60-Day Rehab · 90-Day Rehab · Addiction Retreat · Aftercare and Continuing Care · Anxiety Retreat · Clonidine and Lofexidine Detox · +32 more

Therapies

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Psychosocial Rehab Services · +3 more

Groups served

Support services

Case Management · Community Outreach · Education and Job Training · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intervention Services · Nutrition and Fitness Counseling · +9 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · AmeriHealth · Avmed · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · Devoted Health · Magellan Health · Medicare · Optum · +4 more

Clear Recovery of Cache Valley – Providence

277 North Spring Creek Parkway, Providence, Utah, 84332

5.0★★★★★~~104~~

CARF accredited

PHPIOPOutpatient+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

MATSeniorsYoung adults+6

Clear Recovery of Cache Valley is located at 277 North Spring Creek Parkway in Providence, within 2.0 miles of River Heights and Logan. North Logan, Benson, Hyrum and Hyde Park all sit within 7 miles of the door. Providence is in Cache County, which shapes which public funding routes apply. Clear Recovery of Cache Valley provides partial hospitalization, intensive outpatient and outpatient care. Medication for opioid dependence is available here alongside talking treatment. Addiction and…

2.5 miLittle Logan River37 miOgden Hinckley AirportServes5 towns

Substances treated

Adderall Rehab · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · Dexedrine Rehab · +34 more

Levels of care

Aftercare and Continuing Care · Continuing Care · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · Overdose Prevention Education · +4 more

Therapies

Addiction Counseling · Anger Management · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · +3 more

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Psychosocial Rehab Services · +1 more

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Hepatitis Support Services · HIV and Hepatitis Care · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · +15 more

Support services

Insurance accepted

Aetna · BAS · Bright Health Plans · Cigna Healthcare · Medicaid · Medicare · MotivHealth · Optum · SelectHealth · TRICARE · +1 more

Sober Life Recovery Solutions LLC – San Diego

3930 4th Avenue Suite 300, San Diego, California, 92103

4.9★★★★★48

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicareAccepts TRICARE+3

Co-occurring DisordersMATTrauma-informed+10

Sober Life Recovery Solutions LLC – San Diego is based on 3930 4th Avenue Suite 300 in San Diego, San Diego County. The facility offers partial hospitalization program (PHP), intensive outpatient program (IOP), outpatient services (OP), medication-assisted treatment (MAT), virtual outpatient (telehealth) and dual diagnosis treatment. Care is provided on an outpatient basis, so people continue living at home. This location is registered for both substance use and mental health treatment. Details on this page…

3.0 miSan Diego River1.9 miSan Diego International AirportServes13 towns

Substances treated

Levels of care

Therapies

Mental health

Assertive Community Treatment (ACT) · Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · +6 more

Groups served

Support services

Case Management · Community Outreach · Education and Job Training · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intensive Case Management · Nutrition and Fitness Counseling · +10 more

Insurance accepted

Aetna · Anthem / Elevance Health · Blue Shield of California · Carelon Behavioral Health · Cigna Healthcare · ComPsych · Evernorth Health Services · GEHA · Health Net (Centene) · Humana · +10 more

STR Behavioral Health – Levittown

1400 Veterans Highway, Levittown, PA, 19056

4.8★★★★★~~316~~

Joint Commission

DetoxPHPIOP+2

Accepts InsuranceAccepts MedicareAccepts TRICARE+2

Co-occurring DisordersMATTrauma-informed+9

Deaf and HoH

Records place STR Behavioral Health at 1400 Veterans Highway, Levittown, Pennsylvania. The record shows intensive outpatient and outpatient care. Approved medication is used alongside counseling, which is what medication-assisted treatment means in practice. This is outpatient provision, so daily life continues around the appointments. The listing notes provision for veterans and serving personnel. Registration is federal, through SAMHSA; licensing is held with the Pennsylvania Department of Drug and Alcohol Programs.

4.7 miBurlington Island9.7 miTrenton Mercer AirportServes49 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Outpatient MAT Clinic · Outpatient Rehab · +5 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Cognitive Remediation Therapy · Contingency Management · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · +9 more

Mental health

Alzheimer's and Dementia Care · Assertive Community Treatment (ACT) · Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · First Episode Psychosis · Illness Management and Recovery · Mental Health Conditions · +10 more

Groups served

Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military PTSD Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Trauma Rehab · Active Duty Military TRICARE Rehab · Adult Rehab · Couples Rehab · +65 more

Support services

Case Management · Chronic Illness Management · Community Outreach · Education and Job Training · Employment Support · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · +9 more

Languages

CARF Accredited Deaf and Hard of Hearing Rehab · Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Aetna · Ambetter (Centene) · Cigna Healthcare · ComPsych · Evernorth Health Services · Geisinger Health Plan · Highmark Health · Humana · Independence Blue Cross · Magellan Health · +5 more

Harbor Wellness and Recovery Ctr LLC – Holmdel

2139 Highway 35 North, Holmdel, NJ, 7733

4.9★★★★★54

Joint Commission

PHPIOPOutpatient+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersMATTrauma-informed+8

The provider's premises are at 2139 Highway 35 North, Holmdel, New Jersey. Listed provision covers intensive outpatient and outpatient care. Medication-assisted treatment is part of what is listed, which for opioid dependence means buprenorphine, methadone or naltrexone alongside counseling. Provision is outpatient, so no overnight stay is involved. Telehealth is listed, so some contact can happen without traveling in. Trauma-specific provision is recorded here. The provider appears in the federal treatment register, with state licensing…

2.2 miMount Pleasant Hills19 miNewark Liberty International AirportServes51 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Continuing Care · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · Overdose Prevention Education · Partial Hospitalization Program (PHP) · +3 more

Therapies

12 Step Rehab · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Cognitive Remediation Therapy · Contingency Management · Counseling and Therapy · Couples Counseling · Evidence-Based Therapy · +8 more

Mental health

Assertive Community Treatment (ACT) · Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · +6 more

Groups served

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intensive Case Management · Intervention Services · Peer Support · +6 more

Insurance accepted

AmeriHealth · TRICARE

Social Recovery Center – Springfield

841 Mountain Avenue, Springfield, NJ, 7081

4.9★★★★★49

State licensed

PHPIOPOutpatient+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersMATTrauma-informed+9

Spanish spoken

Social Recovery Center is based at 841 Mountain Avenue in Springfield, New Jersey. The facility is listed for intensive outpatient and outpatient care. The record shows medication-assisted treatment, so buprenorphine or methadone may be available. People attend appointments and go home afterwards, which is how outpatient care works. Remote appointments appear on the record, useful where travel is difficult. Veterans and military families are recorded as a served group. Registration is federal, through SAMHSA; licensing…

2.4 miEast Branch Rahway River8.6 miNewark Liberty International AirportServes89 towns

Substances treated

Levels of care

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · +9 more

Mental health

Groups served

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intervention Services · Practical Support · Recovery Support Services · +3 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Cigna Healthcare · Horizon Blue Cross · Medicare · TRICARE · UnitedHealthcare (UHC)

Evolutions Treatment Center – Fort Lauderdale

2901 West Cypress Creek Road, Fort Lauderdale, FL, 33309

4.7★★★★★~~922~~

Joint Commission

DetoxPHPIOP+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATSeniors+5

Spanish spoken

The listing gives 2901 West Cypress Creek Road, Fort Lauderdale, Florida as the location. What is recorded here is intensive outpatient and outpatient care. The record shows medication-assisted treatment, so buprenorphine or methadone may be available. Treatment is delivered without an overnight stay, around existing commitments. Support for veterans appears on the record. SAMHSA holds the federal registration and the Florida Department of Children and Families the state license.

5.2 miNorth Fork Middle River9.2 miFort Lauderdale Hollywood International AirportServes11 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Outpatient MAT Clinic · Outpatient Rehab · +5 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Evidence-Based Therapy · Group Therapy · Individual Therapy · +4 more

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training

Groups served

Adult Rehab · Court Ordered Dual Diagnosis Rehab · Court Ordered MAT · Court Ordered Medicare Rehab · Court Ordered Outpatient Rehab · Court Ordered Rehab · Court Referral Accepted · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · +17 more

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · Intervention Services · Peer Support · +8 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · AmeriHealth · BCBS (Blue Cross Blue Shield) · Carelon Behavioral Health · Cigna Healthcare · Evernorth Health Services · Humana · Magellan Health · Medicare · Molina Healthcare · +5 more

A Brighter Start Health and Wellness – New Bern

1414 McCarthy Boulevard, New Bern, North Carolina, 28562

4.8★★★★★38

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicaidAccepts Medicare+5

Co-occurring DisordersMATTrauma-informed+9

Based at 1414 McCarthy Boulevard in New Bern, Craven County, North Carolina, A Brighter Start Health and Wellness – New Bern provides dual diagnosis treatment, intensive outpatient program (IOP), medication-assisted treatment (MAT), outpatient services (OP) and partial hospitalization program (PHP). Care runs to a scheduled timetable, so people return home outside sessions. Anyone searching around New Bern may want to check availability and admission criteria directly. The Substance Abuse and Mental Health Services Administration lists…

3.2 miTrent River3.4 miCoastal Carolina Regional AirportServes3 towns

Substances treated

Levels of care

Therapies

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · +5 more

Groups served

Support services

Insurance accepted

Medicaid · Medicare · TRICARE

More Addiction Rehabs That Take Medicare PHP 13–80 of 1,459

Hartford Dispensary – Branford

6-12 Business Park Drive, Branford, Connecticut, 6405

4.8★~~(2,324)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+3

Redeemed Mental Health

456 Old Newport Blvd, Newport Beach, CA 92663

5.0★~~(33)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+2

Elevated Healing Treatment Centers – Woodland Hills

21250 Califa Street, Woodland Hills, California, 91367

4.9★~~(55)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+1

California Prime Recovery – Fountain Valley

17330 Newhope Street Unit A, Fountain Valley, California, 92708

4.7★~~(307)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+3

Amazing Care Mental Health/SUD Servs – Gwynn Oak (5512 Wesley Avenue)

5512 Wesley Avenue, Gwynn Oak, MD, 21207

4.9★~~(17)~~

DetoxInpatientResidential+4Accepts InsuranceAccepts Medicaid+4

STR Behavioral Health – Lancaster

610 Community Way, Lancaster, PA, 17603

5.0★~~(38)~~

PHPOutpatientAccepts InsuranceAccepts Medicare+3

Recovery Cove – Easton

2005 Fairview Avenue, Easton, PA, 18042

4.8★~~(24)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicare+3

A Brighter Start – Wilmington

5710 Oleander Drive, Suite 100, Wilmington, North Carolina, 28403

4.6★~~(107)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+6

Coral CMHC Inc – Miami

2141 SW 1st Street, Miami, FL, 33135

5.0★~~(23)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+4

WisHope Recovery Center – Waukesha

223 Wisconsin Avenue, Waukesha, Wisconsin, 53186

4.6★~~(103)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+5

ChoicePoint – Fair Lawn

23-00 Route 208, Fair Lawn, NJ, 7410

4.6★~~(77)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+4

STR Behavioral Health – Bethlehem

1655 Valley Center Parkway, Bethlehem, PA, 18017

4.8★~~(121)~~

PHPOutpatientAccepts InsuranceAccepts Medicare+3

Bloom Health Centers – Windsor Mill

7001 Johnnycake Road, Windsor Mill, MD, 21244

4.7★~~(143)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+5

BrightView Health – Henderson

500 North Green Street, Henderson, Kentucky, 42420

4.7★~~(40)~~

DetoxPHPOutpatient+2Accepts InsuranceAccepts Medicaid+5

Gateway Foundation – 2323 Stevenson Drive, Springfield

2323 Stevenson Drive, Springfield, Illinois, 62703

4.8★~~(18)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+7

Prime Healthcare Services – Passaic

530 Main Avenue, Passaic, NJ, 7055

4.7★~~(35)~~

ResidentialPHPOutpatient+1Accepts InsuranceAccepts Medicaid+5

Insight Recovery Mental Health – Winchester

7 McKay Avenue, Winchester, Massachusetts, 1890

5.0★~~(17)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+3

Iris Health Clinic – Waukesha

255 West Broadway, Waukesha, Wisconsin, 53186

5.0★~~(9)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+5

Athena Care – Nashville

220 Athens Way, Nashville, Tennessee, 37228

4.6★~~(1,011)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+3

Harbor Care – Nashua (45 High Street)

45 High Street, Nashua, NH 03060

4.5★~~(211)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+7

Bloom Health Centers DC – Washington

1660 L Street NW, Washington, DC 20036

4.7★~~(48)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+5

Complete Healthcare – Columbus (1539 West Broad Street)

1539 West Broad Street, Columbus, OH, 43222

4.6★~~(32)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+5

McKinley Hall Inc – Springfield

2624 Lexington Avenue, Springfield, OH, 45505

4.7★~~(17)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+5

Aspire Counseling Services LLC – San Luis Obispo

895 Aerovista Place Suite 106, San Luis Obispo, California, 93401

4.7★~~(41)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+3

Amazing Care Mental Health/SUD Servs – Baltimore (4813 Seton Drive)

4813 Seton Drive, Baltimore, MD, 21215

4.9★~~(17)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+6

Amazing Care Mental Health/SUD Servs – Gwynn Oak (5906 Howard Place)

5906 Howard Place, Gwynn Oak, MD, 21207

4.9★~~(17)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+3

NYC/HHC Queens Hospital Center – Jamaica

82-68 164 Street, Jamaica, NY, 11432

4.7★~~(1,799)~~

InpatientPHPOutpatient+2Accepts InsuranceAccepts Medicaid+5

MedStar Saint Marys Hospital – Leonardtown

25500 Point Lookout Road, Leonardtown, MD, 20650

4.5★~~(2,658)~~

InpatientPHPOutpatient+1Accepts InsuranceAccepts Medicaid+5

Clarity Clinic – North Michigan Avenue, Chicago

333 North Michigan Avenue, Chicago, Illinois, 60601

4.5★~~(439)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+1

Lennard Clinic Inc – Newark

461 Frelinghuysen Avenue, Newark, NJ, 7114

4.4★~~(165)~~

DetoxPHPIOP+3Accepts MedicaidAccepts Medicare+4

Amherst H Wilder Foundation – Saint Paul

451 Lexington Parkway North, Saint Paul, Minnesota, 55104

4.4★~~(136)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+4

Riverbend – Lowell

101 Jackson Street, Lowell, Massachusetts, 1852

4.5★~~(61)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+6

Memorial Health Univ Medical Center – Savannah

4700 Waters Avenue, Savannah, Georgia, 31404

4.4★~~(7,331)~~

InpatientPHPOutpatient+1Accepts InsuranceAccepts Medicaid+5

NYC HHC Bellevue Hospital Center – New York

462 1st Avenue, New York, NY, 10016

4.4★~~(6,473)~~

InpatientPHPOutpatient+1Accepts InsuranceAccepts Medicaid+6

Wausau Comprehensive Treatment Center – Wausau

210 Washington Street, Wausau, Wisconsin, 54403

4.4★~~(101)~~

DetoxPHPOutpatient+2Accepts InsuranceAccepts Medicaid+5

CHI Saint Alexius Medical – Bismarck

1120 East Main Avenue, Bismarck, ND 58501

4.3★~~(685)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+5

New Era Rehabilitation Center Inc – New Haven

311 East Street, New Haven, Connecticut, 6511

4.4★~~(29)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+4

North Crown Heights – Brooklyn

765 Nostrand Avenue, Brooklyn, NY, 11216

4.4★~~(27)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+3

APEX Recovery San Diego

2810 Camino del Rio S #106, San Diego, CA 92108, United States

4.4★~~(119)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicare+6

Assisted Recovery Centers of America – Saint Louis (Olive Street)

1430 Olive Street, Suite 100, Saint Louis, Missouri, 63103

4.3★~~(167)~~

DetoxPHPIOP+5Accepts InsuranceAccepts Medicaid+5

Arbour Counseling Services – Norwell

384 Washington Street, Norwell, Massachusetts, 2061

4.3★~~(56)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+4

Lotus Recovery LLC – Saint Paul

1 West Water Street, Saint Paul, Minnesota, 55107

4.6★~~(10)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+3

Way Home Treatment Center – Fort Lauderdale (1100 West Oakland Park Boulevard)

1100 West Oakland Park Boulevard, Fort Lauderdale, FL, 33311

4.3★~~(47)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+5

Chemical Abuse Services Agency Inc – Arctic Street, Bridgeport

690 Arctic Street, Bridgeport, Connecticut, 6608

5.0★~~(3)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+6

American Habitare and Counseling Inc – Newark

687 Frelinghuysen Avenue, Newark, NJ, 7114

4.3★~~(30)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+3

Adapt Integrated Healthcare – North Bend

400 Virginia Avenue, Suite 201, North Bend, Oregon, 97459

4.3★~~(87)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+6

Circle Health Services – Cleveland (5209 Detroit Avenue)

5209 Detroit Avenue, Cleveland, OH, 44102

4.3★~~(184)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+6

River Valley Health – Morristown

815 West 5th North Street, Morristown, Tennessee, 37814

4.3★~~(171)~~

PHPOutpatientTelehealth+1Accepts InsuranceAccepts Medicaid+6

Buckeye Clinic – Columbus (3121 West Broad Street)

3121 West Broad Street, Columbus, OH, 43204

4.9★~~(152)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+3

Bloom Health Center – Annapolis

1750 Forest Drive, Annapolis, MD, 21401

4.3★~~(104)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+5

Compassion Recovery

23141 Moulton Pkwy, Laguna Hills, CA 92653, United States

5.0★~~(65)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicare+4

Allover Healthcare Group – Baltimore

5450 Reisterstown Road, Baltimore, MD, 21215

5.0★~~(149)~~

PHPIOPOutpatient+3Accepts InsuranceAccepts Medicaid+5

B Riley Sober Home – Cleveland

2121 West 117th Street, Cleveland, OH, 44111

4.3★~~(56)~~

ResidentialPHPOutpatientAccepts InsuranceAccepts Medicaid+5

Akua Behavioral Health

20271 SW Birch St #200, Newport Beach, CA 92660, United States

4.3★~~(101)~~

DetoxHospital detoxInpatient+6Accepts InsuranceAccepts Medicaid+5

Buckeye Clinic – Columbus (4252 East Main Street)

4252 East Main Street, Columbus, OH, 43213

5.0★~~(31)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+3

Dynamic Healing Center – Honolulu

200 North Vineyard Boulevard, Honolulu, HI 96817

5.0★~~(3)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+5

ASCEND Csl and Recovery Services – Portsmouth

729 6th Street, Portsmouth, OH, 45662

4.3★~~(17)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicaid+5

Addiction Recovery Centers (ARC) – Ashland

2221 Central Avenue, Ashland, Kentucky, 41101

4.8★~~(108)~~

DetoxResidentialPHP+4Accepts InsuranceAccepts Medicaid+3

Memorial Behavioral Health Counseling – Springfield

901 North 1st Street, Springfield, Illinois, 62702

5.0★~~(4)~~

PHPOutpatientAccepts InsuranceAccepts Medicaid+3

Way Home Treatment Center – Fort Lauderdale (3223 NW 10th Terrace)

3223 NW 10th Terrace, Fort Lauderdale, FL, 33309

4.3★~~(47)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+4

Sober Life Recovery Solutions

3930 Fourth Ave Ste 300A, San Diego, CA 92103, United States

4.9★~~(48)~~

DetoxPHPIOP+3Accepts InsuranceAccepts Medicare+3

Maryland Wellness and Recovery – Rockville

6210 Montrose Road, Rockville, MD, 20852

4.8★~~(58)~~

DetoxResidentialPHP+5Accepts InsuranceAccepts Medicaid+6

NYC Health and Hospital/Kings – Brooklyn

451 Clarkson Avenue, Brooklyn, NY, 11203

4.2★~~(4,942)~~

InpatientPHPOutpatient+2Accepts InsuranceAccepts Medicaid+6

Nulease Medical Solutions – Louisville

5722 Outer Loop, Louisville, Kentucky, 40219

4.7★~~(175)~~

DetoxPHPIOP+4Accepts InsuranceAccepts Medicaid+5

AdCare Outpatient – Worcester

95 Lincoln Street, Worcester, Massachusetts, 1605

4.9★~~(59)~~

PHPIOPOutpatient+2Accepts InsuranceAccepts Medicaid+4

Mental Health Clinic of Passaic – Clifton

1451 Van Houten Avenue, Clifton, NJ, 7013

4.5★~~(8)~~

PHPOutpatientTelehealthAccepts InsuranceAccepts Medicaid+4

LEADER – Belmont

115 Mill Street, Belmont, Massachusetts, 2478

5.0★~~(2)~~

ResidentialPHPOutpatient+1Accepts InsuranceAccepts Medicaid+4

Quincy Comprehensive Treatment Center – Quincy

460 Quincy Avenue, Quincy, Massachusetts, 2169

5.0★~~(2)~~

InpatientPHPOutpatient+1Accepts InsuranceAccepts Medicaid+4

Why Trust RehabSeekers.com?

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Common questions

Answered from what is listed here.

Does Medicare cover partial hospitalization?

Yes. Medicare Part B covers partial hospitalization when it is furnished by a hospital outpatient department or a Medicare-certified community mental health center and you meet the requirements, including a physician certification that you would otherwise need inpatient psychiatric care.

Coverage applies only when the qualified mental health professional and the program both accept assignment.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

How many hours a week is Medicare PHP?

At least 20 hours a week of therapeutic services. A physician must certify that need, and the plan of care has to show it. Medicare describes a partial hospitalization day as usually running 4 to 8 hours, so the week is typically spread across several full days.

The 2026 payment rule also pays partial hospitalization per diem based on a minimum of 20 hours of services per week.

Partial Hospitalization Program (PHP)https://rehabseekers.com/programs/outpatient/php/

How many days a week is a Medicare PHP?

Medicare sets weekly hours rather than a national minimum number of days. One Medicare contractor policy states that attending four days a week, totaling 20 hours of program services in the plan of care, is the minimum level of active treatment considered reasonable and necessary.

Because that figure comes from a regional contractor policy rather than national rules, ask the program how its week is scheduled.

Partial Hospitalization Program (PHP)https://rehabseekers.com/programs/outpatient/php/

Do I have to need inpatient care to qualify for Medicare PHP?

Yes. On admission a physician must certify that you would require inpatient psychiatric hospitalization if partial hospitalization were not provided, and that you need at least 20 hours of services weekly. Eligible groups include those leaving an inpatient program and those at reasonable risk of needing admission.

Medicare Inpatient Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-inpatient-rehab/

What is the difference between PHP and IOP under Medicare?

Partial hospitalization requires at least 20 hours of therapeutic services a week and a certification that you would otherwise need inpatient psychiatric care. An intensive outpatient program requires at least 9 hours a week, and you do not need to qualify for inpatient treatment to receive it.

Medicare began covering intensive outpatient services under Part B on January 1, 2024.

Medicare IOPhttps://rehabseekers.com/insurance-accepted/medicare/medicare-iop/

Does Medicare PHP cover substance use treatment?

Yes. The CMS manual names substance use disorders among the conditions treated in partial hospitalization, alongside mood disorders, psychotic disorders and eating disorders. Published guidance states that an earlier restriction barring coverage when substance use was the primary diagnosis is no longer part of Medicare coverage.

One contractor policy adds that a program must be prepared to treat substance use as a co-occurring condition when it is present.

Medicare Dual Diagnosis Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-dual-diagnosis-rehab/

How much does Medicare partial hospitalization cost?

After the annual Part B deductible, which is $283 in 2026, you pay 20% of the Medicare-approved amount for each professional service plus coinsurance for each day of partial hospitalization at a hospital outpatient department or community mental health center.

Whether the hospital department or a freestanding site bills the claim can change your share, so ask before admission.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

What does a Medicare PHP day include?

Individual and group psychotherapy from physicians, psychologists or other state-licensed professionals, plus occupational therapy, psychiatric nursing, peer support navigation, non-self-administered drugs, individualized activity therapies, family and caregiver counseling, patient education and diagnostic services.

One contractor policy says group therapy should be limited to ten or fewer participants.

Group Therapyhttps://rehabseekers.com/therapies/counseling-and-therapy/group-therapy/

How often does a doctor have to recertify PHP?

The first physician recertification is required as of the 18th calendar day after admission. After that, the provider sets the schedule, but recertification must happen no less often than every 30 days for coverage to continue.

Each recertification must state that you would otherwise need inpatient care and describe your response to treatment and discharge goals.

Medicare Mental Health Treatmenthttps://rehabseekers.com/insurance-accepted/medicare/medicare-mental-health-treatment/

Does Medicare pay for meals or transportation to PHP?

No. The CMS manual excludes meals, transportation, vocational training, self-administered medications and services to hospital inpatients from partial hospitalization. Medicare also does not cover social support groups or job skills testing that is not part of treatment.

Since partial hospitalization means traveling there and back daily, distance from home is worth weighing early.

Medicare Outpatient Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-outpatient-rehab/

Can I join a PHP if I am stable on medication?

Generally no. The CMS manual says a program that only monitors medication for someone whose condition is otherwise stable lacks the structure and intensity of active treatment. Benefit-category denials cover stable patients, wellness programs with no hospitalization risk, and mainly social or recreational day care.

If you do not meet that severity, Part B professional services such as psychiatrist or psychologist visits may still fit.

Psychiatric Medication Managementhttps://rehabseekers.com/mental-health/mental-health-treatment/psychiatric-medication-management/

Does Medicare Advantage cover PHP?

Yes, Medicare Advantage plans must cover partial hospitalization and must follow Traditional Medicare national and local coverage determinations when judging medical necessity. Prior authorization is common: in 2022, 92% of Medicare Advantage enrollees were in plans requiring it for partial hospitalization.

Standard authorization decisions are due within seven calendar days, expedited ones within 72 hours.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

What can I do if my PHP is denied?

An Original Medicare appeal can move through five levels, and every decision letter explains how to reach the next one. In Medicare Advantage, you start with a reconsideration filed with the plan within 65 days of the denial notice date.

A fast appeal brings a decision within 72 hours when waiting could seriously jeopardize life, health or the ability to regain maximum function.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

Is PHP the same as residential treatment under Medicare?

No. Partial hospitalization is a day program under Part B: you attend structured treatment and go home each evening, with no 24-hour supervision. Published guidance states that Original Medicare does not cover non-hospital residential substance use treatment programs at all.

You must have an adequate support system outside the program and not be an imminent danger to yourself or others.

Medicare Residential Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-residential-rehab/

What happens after a Medicare PHP ends?

Two paths are built into the benefit. The CMS manual says you may step up to inpatient care if 24-hour supervision becomes necessary, or step down to less intensive outpatient treatment once symptoms stabilize and the acute dysfunction eases.

Each recertification must describe goals for discharge coordination, so planning starts well before the final day.

Aftercare and Continuing Carehttps://rehabseekers.com/programs/aftercare-and-continuing/

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Medicare’s partial hospitalization benefit, written as PHP on most intake forms, buys a day of structured treatment that a member goes home from each evening. The weekly floor is 20 therapeutic hours. Part B funds it, and only inside a hospital outpatient department or a community mental health center certified by Medicare. The manual’s own comparison is to a highly structured, short-term hospital inpatient program.

What marks this benefit off from every lighter outpatient level is a single written finding. On admission a physician has to record that, absent partial hospitalization, the member would need inpatient psychiatric hospitalization. Hours alone will not carry a claim: that finding is what makes a day program a Medicare PHP, and it has to be restated each time the stay is recertified.

What follows sets out the eligibility tests Medicare applies, the contents and the exclusions of a covered day, the 20-hour threshold and the attendance pattern underneath it, where PHP parts company with intensive outpatient treatment, the recertification clock, the two charges a member faces in 2026, how the program itself gets paid, how an advantage plan gates the benefit, and how to locate a certified program.

Does Medicare Cover Partial Hospitalization?

Yes, Part B pays for it in two settings only: a hospital outpatient department, or a community mental health center certified by Medicare. Admission turns on a physician’s written finding that inpatient psychiatric hospitalization would be needed without the program, together with a plan of care scheduling 20 or more therapeutic hours weekly.

Substance use disorders sit squarely inside the category. The CMS manual offers substance use disorders, eating disorders, psychotic disorders and mood disorders as its worked examples, and published guidance indicates that an older bar on partial hospitalization where substance use was the primary diagnosis has dropped out of Medicare coverage. Where a substance use disorder accompanies a mental health condition, one Medicare contractor policy expects the program to be ready to treat the two together, the same expectation described on the Medicare rehab page.

Who Medicare Says Qualifies

Two groups are named. One is a member leaving an inpatient program, where the PHP stands in for a continued inpatient stay. The other is a member at reasonable risk of needing hospitalization without it. For both, the manual looks for acute dysfunction arising from a mental disorder, substance use disorders included, severe enough to disrupt several parts of daily life at once. Where round-the-clock supervision later becomes necessary, the route back up to Medicare inpatient rehab stays open.

Capacity to use the program is tested separately. Support has to exist at home, 24-hour supervision must not be required, the member must pose no imminent danger to self or others, and there must be enough cognitive and emotional reserve to engage in active treatment and withstand its pace. A contractor policy layers on written informed consent from the member or a legal guardian, and asks that absences and their causes be entered in the medical record.

Inside a Covered PHP Day

Billable content runs to individual and group psychotherapy, occupational therapy, psychiatric nursing, peer support navigation, drugs that cannot be self-administered, individualized activity therapies, counseling for family members and caregivers, patient education and diagnostic work. Talk therapy may be delivered by a physician or psychologist and by other state-licensed professionals: certified alcohol and drug counselors, clinical nurse specialists, marriage and family therapists, mental health counselors and licensed clinical social workers among them. Group work is capped at ten participants under one contractor policy, which is why a program handling co-occurring conditions tends to run several small groups rather than one large one.

Items the Benefit Excludes

Outside the benefit: meals, transportation, medications a member takes without help, vocational training, and anything furnished to a hospital inpatient. A day program built mainly around social, recreational or diversionary activity falls outside it too, as does a wellness-maintenance program with no hospitalization risk attached. A member whose condition has settled, or whose remaining need is medication review, belongs instead in Medicare outpatient rehab; the manual adds that failing the severity test does not rule out Part B professional services such as psychiatrist or psychologist visits.

What Is the 20-Hour Rule for Medicare PHP?

Twenty therapeutic hours a week, certified by a physician and written into the plan of care, is the floor. A day typically fills 4 to 8 of those hours. One Medicare contractor policy reads four attendance days totaling 20 hours as the least active treatment it will call reasonable.

That same policy expects the program to keep 20 hours of weekly availability open, and rules partial hospitalization out for a member who needs 24-hour supervision, who misses sessions repeatedly, or whose plan of care cannot sustain 20 hours of programming. The manual draws a related line: where medication is simply being monitored for a member whose condition has steadied, the combination, structure and intensity that define active treatment are absent.

Is PHP the Same as IOP Under Medicare?

No, two tests set them apart. Partial hospitalization demands 20 weekly hours plus the certification that inpatient psychiatric hospitalization would otherwise follow. Medicare IOP asks for nine hours, and nothing in its rules turns on whether a member would otherwise need an inpatient bed.

Setting is the second divide. Payment for partial hospitalization reaches only the hospital outpatient department and the certified community mental health center, while intensive outpatient billing extends to Opioid Treatment Programs, Rural Health Clinics and Federally Qualified Health Centers as well. Away from Medicare, the American Society of Addiction Medicine retitled this level High Intensity Outpatient in its fourth edition criteria, calling partial hospitalization a misnomer because the care is not given in a hospital; that body regulates nothing, so adoption of the new name rests with states and payers.

How Often Must a Doctor Recertify a Medicare PHP?

Day 18 is the first deadline: recertification falls due as of the eighteenth calendar day after admission. The program then picks its own interval, so long as no more than 30 days pass between recertifications, and each one has to repeat the finding about inpatient psychiatric care being needed otherwise.

Treat it as clinical writing, not paperwork. Alongside that finding, a recertification describes how the member has responded so far, names the symptoms still carrying hospitalization risk, and sets goals for coordinating discharge. Two exits are described in the manual: upward to inpatient care where 24-hour supervision is needed, or downward to a lighter outpatient schedule once symptoms settle.

Day 18 is the date to diarize. The first recertification attaches to the eighteenth calendar day after admission rather than to a round number of weeks, and every later one has to land inside 30 days. A member or a family member can ask the admissions team when each falls due, since a recertification that never got written is a common reason a PHP claim fails.

What Will a Member Owe for PHP in 2026?

$283 is the 2026 Part B deductible; once it is met, a member owes 20% of the Medicare-approved amount on each professional service and a separate per-day coinsurance charged by the outpatient hospital department or community mental health center. Medicare publishes no dollar figure for that daily share.

Coverage hangs on assignment. Both the program and the doctor or other qualified mental health professional have to accept it, which means taking what Medicare allows as payment in full. There is no annual ceiling on spending in Original Medicare, something that tells over a long course of day treatment. Medicare Advantage works the other way and limits in-network out-of-pocket costs: the 2026 cap is $9,250, with an enrollment-weighted average of $5,421.

Typical US market rates before insurance
Level of care	Monthly	Daily
Medical detox (7–14 days)	$1,500 – $5,200 per week	$215 – $745
Residential inpatient	$6,200 – $26,000	$205 – $865
PHP	$7,200 – $14,000	$240 – $465
IOP	$2,700 – $9,200	$90 – $305
Outpatient	$1,300 – $5,200	$45 – $175

Those are billing amounts where nobody is covering the care. Statewide figures put the middle half of partial hospitalization prices at $7,000 to $15,000 a month, or $230 to $500 a day. Neither Medicare nor Medicaid pays sums like that, since each works from its own fee schedule; TRICARE contributes a cost share, a private plan runs the charge through its deductible and coinsurance, and only self-pay meets the published daily rate in full. Part B gates this level with the physician certification and the plan of care rather than a request for pre-approval.

The 2026 Per Diem Structure

Payment arrives as a per diem, conditioned on that 20-hour minimum week. Two rate bands carried into 2026 for each type of provider: one covers a day on which three services are furnished, the other a day with four or more, so what the program fits into the day decides the rate. Community mental health center costs for 2026 were pegged at 40 percent of the final hospital-based partial hospitalization figure.

Does a Medicare Advantage Plan Have to Approve PHP First?

Yes, usually. Prior authorization gated partial hospitalization for 92% of Medicare Advantage enrollees in 2022. Plans owe a standard decision inside seven calendar days and an expedited one inside 72 hours. Original Medicare seldom asks for anything in advance, leaning on the physician certification as its only gate.

A plan cannot write its own clinical test, though. Judgments about medical necessity are bound by Traditional Medicare’s national and local coverage determinations, so the 20-hour threshold, the inpatient-level finding and the recertification cadence weigh exactly as much inside an advantage plan as outside one. Network and referral rules are where a plan does have room, and it can require an in-network Opioid Treatment Program where medication treatment forms part of the plan of care.

Can a Denied PHP Day Be Appealed?

Yes, Original Medicare runs appeals through five levels, and each decision letter sets out the route to the one above. Under Medicare Advantage the opening move is a reconsideration lodged with the plan, due inside 65 days of the denial notice date, with 72 hours the limit on a fast appeal.

Know which denial you are facing. A benefit-category denial says this was never partial hospitalization, usually because the day was mainly social or recreational or because the member had already steadied on medication. A reasonable and necessary denial says the member would not or could not join in active treatment, could not withstand its intensity, or had a chronic condition with no acute flare. The paperwork that answers each is different.

How Do I Find a Medicare-Certified PHP Near Me?

The provider search is Care Compare on medicare.gov, and the Medicare help line answers at any hour on 1-800-633-4227, with a TTY line on 1-877-486-2048. Two questions matter at intake: is this a hospital outpatient department or a certified community mental health center, and does it accept assignment?

Government treatment registers carry state-licensed options. On 877-839-2675 a State Health Insurance Assistance Program counselor gives free one-on-one guidance about a plan. Anyone in immediate distress can call or text 988 at any hour, and 911 remains the route in a medical crisis.

Programs that accept Medicare for day treatment are gathered on the Medicare PHP page, with related pages for senior PHP and Medicare mental health treatment. Each listing shows the levels of care offered, the payments the program says it accepts, licensing and accreditation shown where The Joint Commission or CARF lists the facility, and how far the site sits from the nearest airport.

References and Citations

Centers for Medicare & Medicaid Services — Medicare Benefit Policy Manual provisions on partial hospitalization: eligible groups, severity and participation requirements, physician certification and recertification at day 18 and every 30 days, covered services, exclusions and categories of denial.
Centers for Medicare & Medicaid Services — calendar year 2026 outpatient payment rule covering partial hospitalization per diem categories and community mental health center costs set at 40 percent of hospital-based costs.
Medicare local coverage determination on psychiatric partial hospitalization — program availability, the four-day and 20-hour pattern, group size, written consent, documentation of absences and co-occurring substance use.
American Society of Addiction Medicine — fourth edition criteria renaming this level High Intensity Outpatient, and the society’s note that it is not a regulatory body.
Medicare.gov and KFF — 2026 Part B deductible and coinsurance, assignment rules, Medicare Advantage prior authorization rates and decision timelines, 2026 maximum out-of-pocket limits, and appeal levels.
RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by facility, length of stay and coverage.