Your Medicare Coverage

Is my test, item, or service covered?

Mental health care (partial hospitalization)

How often is it covered?

Medicare Part B (Medical Insurance) covers partial hospitalization. Partial hospitalization services are provided under a partial hospitalization program, furnished by a hospital to its outpatients or by a community mental health center.

Who's eligible?

To be eligible for partial hospitalization services, a doctor must certify that you would otherwise need inpatient treatment.

Your costs in Original Medicare

You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other mental health qualified professional 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.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Related resources

If you need immediate help for yourself or someone in a crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK or 1-800-SUICIDE (1-800-273-8255). TTY users should call 1-800-799-4TTY (1-800-799-4889).  

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