Mental health care (partial hospitalization)
Medicare Coverage Information
Overview
Medicare provides coverage for partial hospitalization mental health programs as an alternative to inpatient hospital care. These intensive outpatient programs help patients receive comprehensive psychiatric treatment while maintaining daily life activities.
- Covers structured mental health treatment programs
- Must be prescribed by a Medicare-approved physician
- Requires medical necessity documentation
- Provides intensive outpatient psychiatric services
- Includes individual and group therapy sessions
- Medicare Part B beneficiaries
- Patients with diagnosed mental health conditions
- Individuals requiring intensive outpatient treatment
- Must have physician referral
- Typically covered under Medicare Part B
- Beneficiary pays 20% of Medicare-approved costs
- Annual Part B deductible applies
- Potential copayments for individual services
- Requires physician certification of medical necessity
- Limited to programs meeting specific Medicare guidelines
- Must be provided by Medicare-certified community mental health centers
- Number of covered sessions may be restricted
- Consult with primary care physician about partial hospitalization needs
- Verify program certification with Medicare
- Check specific coverage details with your Medicare plan
- Contact 1-800-MEDICARE for precise coverage information
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicaremental healthpartial hospitalizationpsychiatric caremental health coverage
Related Coverage Topics
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