What Is a Partial Hospitalization Program (PHP)? Hours, Cost, and Who It Fits

A partial hospitalization program, or PHP, is a day treatment program for addiction or mental health. You spend most of the day at the facility, usually five days a week, and go home at night. It is the most intensive level of care that does not involve sleeping at the treatment center, which makes it a common step down from inpatient rehab before IOP or standard outpatient care.

The name is a leftover. Few PHPs run inside a hospital anymore, and the American Society of Addiction Medicine now calls this level of care "high intensity outpatient" in the fourth edition of its placement criteria, with the note that "PHP is a misnomer as these services are not delivered in a hospital setting." Programs, insurers, and directories still say PHP, so this page does too.

What a PHP looks like day to day

Medicare's definition is a useful benchmark because many insurers borrow from it: a structured program of at least 20 hours of therapeutic services a week, usually 4 to 8 hours a day. A typical addiction PHP runs something like a school or work day, Monday through Friday, and includes:

• Group therapy, usually several sessions a day
• Individual therapy at least once a week
• Medication management with a psychiatrist or nurse practitioner, including medications for opioid or alcohol use disorder where appropriate
• Education on relapse prevention, cravings, and coping skills
• Family sessions, often weekly or every other week
• Case management for housing, work, legal issues, and aftercare planning

Many people in PHP live at home. Others live in a sober living house connected to the program, which is common when home is not a safe place to be sober yet.

PHP compared with inpatient and IOP

• Inpatient or residential rehab: you live at the facility with staff around the clock. Best when withdrawal needs medical monitoring, when home is not safe, or when earlier outpatient attempts have not held.
• Partial hospitalization: 20 or more hours a week of treatment, home at night. For people who are medically stable and do not need overnight supervision but do need daily structure.
• Intensive outpatient (IOP): fewer hours, usually three or four sessions a week and often in the evening, so you can work or go to school around it.
• Standard outpatient: one or two sessions a week for ongoing support.

People commonly move through these in order. A course of treatment might run detox, then a few weeks of residential, then PHP, then IOP for a couple of months. Others start at PHP because they cannot take a month away from kids or a job.

Who PHP fits

PHP tends to be a good match when:

• You have finished detox or do not need one, and you are medically stable.
• You need more than a few hours a week of treatment to stay sober right now.
• You have somewhere safe and supportive to sleep, whether that is home or sober living.
• You have a co-occurring condition like depression, anxiety, or PTSD that needs regular psychiatric attention alongside addiction treatment. Most PHPs are set up for dual diagnosis treatment.
• You can get to the program every day. Transportation is a practical dealbreaker more often than people expect.

It tends to be a poor match if you are still in acute withdrawal, if you have relapsed repeatedly in outpatient care, or if the people you live with are still using.

How long PHP lasts

There is no fixed length. A few weeks is typical, with insurers reviewing progress every week or two and approving more days based on medical necessity. A good program tells you at admission what its usual range is and what would trigger a step up or a step down.

Cost and insurance

PHP is usually billed per day. Many commercial plans and state Medicaid plans cover it, and Medicare covers it when your care plan documents that you need at least 20 hours a week of therapeutic services. Before you commit, ask the program to run a verification of benefits and put your expected out-of-pocket cost in writing. Ask specifically whether the program is in network, since out-of-network PHP bills can be large.

Questions to ask a PHP before you enroll

• How many hours a day and days a week does the program run?
• Who provides individual therapy, and how often?
• Is there a psychiatrist or prescriber on site, and can they prescribe buprenorphine or naltrexone if I need it?
• Is the program licensed by the state, and is it accredited by the Joint Commission or CARF?
• What happens if I relapse during the program?
• Do you offer sober living, and is it a separate cost?
• What does step-down look like, and do you run your own IOP?
• Can you verify my insurance and give me an estimate before I start?

The Sober Nation step-by-step guide to choosing a rehab covers accreditation and licensing in more depth. You can search treatment centers by state in the directory, and the getting sober hub covers what comes after treatment.