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TRICARE's Partial Hospitalization Program Provides Support


If you or a family member needs behavioral health care support beyond the available outpatient services, your physician may suggest a TRICARE-authorized partial hospitalization program (PHP). A PHP is recommended when your physician believes it is necessary to stabilize a critical behavioral health disorder or to transition from an inpatient program to an outpatient program.

TRICARE’s PHP benefit provides up to 60 treatment days per fiscal year (Oct. 1–Sept. 30) or in a single admission for a TRICARE-authorized psychiatric PHP program. This 60-day limit does not count toward TRICARE’s inpatient treatment limits of 30 days for adults and 45 days for patients 18 or younger per fiscal year. For substance use disorders, the PHP benefit provides up to 21 treatment days per fiscal year.

Treatment in a PHP takes place in an outpatient setting and provides a program of medical therapeutic services at least three hours per day, up to five days per week. Treatment may include full- or half-day programs and can take place during the day, evening, night or weekend.

Because there are no “emergency” admissions to a PHP, prior authorization is required for all PHP admissions. Prior authorization is also required when a behavioral health care facility transfers a patient internally to a lower level of care.

Please be aware that the number of TRICARE-authorized PHPs is limited. For a current listing of TRICARE network PHPs, refer to the Find a TRICARE Provider feature or call 1-800-444-5445.

If you think treatment in a PHP might be useful to you or a family member, talk to your primary care manager about available TRICARE-authorized programs.
 
Last Update: May 24, 2010