Medicare provides payment for outpatient psychiatric hospital services when they are medically reasonable and necessary for the purpose of diagnostic study or be reasonably expected to improve the patient's condition.
- Community Mental Health Center (CMHC) Partial Hospitalization Program (PHP) Billing Guide
- Hospital-based Partial Hospitalization Program (PHP) Billing Guide
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Section 260 - Explains billing requirements for the Partial Hospitalization Program
- CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 6, Section 70 – Defines what outpatient psychiatric services are as well as specific coverage guidelines for the various services provided
- CMS Medicare Learning Network (MLN) Matters Special Edition (SE)1607
Last Updated Apr 13, 2017