What weekly hours does Medicare set for partial hospitalization and intensive outpatient programs?

Under Medicare, a partial hospitalization program is for patients who need at least 20 hours a week of therapeutic services, and an intensive outpatient program is for patients who need at least 9 hours a week (42 CFR 410.43 and 410.44). Those are minimums set in each patient's plan of care. The program sets the days and hours, so ask it for the weekday schedule before booking a series.

Does Medicare pay for transportation to a partial hospitalization or intensive outpatient program?

No. The Medicare Benefit Policy Manual lists meals, self-administered medications and transportation among the items excluded from both partial hospitalization and intensive outpatient services. A patient with Original Medicare only has to get the ride from the program, the family or another source. A patient who is also on Medicaid may qualify for a Medicaid ride when Medicaid covers the service.

Can a Medicaid member get a ride to a partial hospitalization program?

When the program is a service Medicaid covers for that member and the member has no other way to get there, yes. CMS says states must consider a member's behavioral health needs when choosing the type of ride. Coverage of the program itself, and how rides are booked, depends on the state and the plan, so the program's intake staff and the broker are the first calls.

How often does a program have to renew a patient's certification?

For Medicare partial hospitalization, the first recertification is required as of the 18th day and later ones at least every 30 days. For Medicare intensive outpatient services, recertification comes no less often than every 60 days after the first certification. A ride series that mirrors those dates lets the program and the payer confirm that the patient is still attending.

What should a ride company do when a program rider stops showing up?

Tell the payer and the program, and keep offering the rides. CMS guidance bars a state from denying rides because of no-shows or late arrivals, and bars charging the member. A county contract can ask for more: Hamilton County, Ohio, asks its vendor to flag any rider with three or more no-shows in a week. The program often knows why before the ride company does.

Do privacy rules for substance use treatment apply to these trips?

They can. Part 2 of 42 CFR protects records that identify a patient as having a substance use disorder when they come from a federally assisted program, and a Medicare-participating provider counts as federally assisted. A program that treats substance use may ask a ride company to sign a qualified service organization agreement before it shares rider names. Keep the destination off the manifest wherever you can.

Partial Hospitalization Program Transportation: Rides

What do PHP and IOP rides look like?

A partial hospitalization program (PHP) and an intensive outpatient program (IOP) both mean rides on every program day for as long as the patient is enrolled, and what separates them for a ride company is the hours. Medicare sets two floors in its rules. A PHP serves patients who need a minimum of 20 hours a week of therapeutic services (42 CFR 410.43(c)). An IOP serves patients who need a minimum of 9 hours a week (42 CFR 410.44(c)). The Medicare Benefit Policy Manual puts an IOP at a level more intense than outpatient day treatment but less intense than a PHP.

Those are weekly hours of services in the patient’s plan of care, not a number of days, so the program’s own schedule decides the rides. Two examples show how the days can come out. A program that runs four hours a day on five days meets the 20 hour floor and means five round trips a week. A program that runs three hours a day on three days meets the 9 hour floor and means three. Programs pick their own patterns, so ask each one for its weekday schedule, its start and end time each day, and the entrance riders should use.

Medicare pays for a PHP when a hospital outpatient department or a Medicare-certified community mental health center provides it. An IOP can also come from a rural health clinic, a federally qualified health center, or an opioid treatment program. The weekly hours above are Medicare’s, so for any new program ask which payer rules it follows and who funds the ride. Rides to other mental health and substance use programs are in behavioral health transportation.

Who rides a PHP or IOP van?

Riders are people who do not need 24-hour care, and ordinary NEMT usually fits the rider the federal criteria describe. Both programs share the same criteria: patients have a mental health or substance use disorder diagnosis, do not require 24-hour care, have an adequate support system while not in the program, are not judged to be dangerous to self or others, and can take part in active treatment. A PHP is also described as an alternative to inpatient psychiatric care, either after a hospital stay or for a patient at risk of one, according to the Medicare manual.

That is a different rider from the one who needs secure or protected transport. A rider’s condition can still change, and a driver who sees a rider in crisis follows the company’s emergency steps. The guide to behavioral health transportation covers where secure transport licensing starts, and the mental health first aid guide covers what drivers say and do. The behavioral health guide also lists the intake questions to ask at booking.

How long does a PHP or IOP ride series last?

A series lasts as long as the program’s physician keeps certifying the patient, and the certification schedule tells you when to expect a renewal. In Medicare PHP the first recertification is required as of the 18th day of services, and later ones at least every 30 days. In IOP, recertification comes at least every 60 days after the first certification (42 CFR 424.24(d) and (e); Benefit Policy Manual sections 70.3 and 70.4). At each of those dates the physician states that the patient still needs the program. Ask the program when each recertification falls, and review the ride series on those dates.

A patient can leave the program in the middle of a series, and a ride series that outlives the patient’s last day produces dry runs. Ask the program to tell you the planned end date, and ask the payer to end or change the series when the program does. The standing orders guide covers how approvals are set up and renewed. The no-show guide covers the reminders that keep a rider on a long series.

Who pays for PHP and IOP rides?

Medicare’s PHP and IOP benefits do not pay for the ride, so the payer is Medicaid, the program, a county, or the family. The Medicare Benefit Policy Manual excludes meals, self-administered medications and transportation from the scope of both partial hospitalization and intensive outpatient services. Rides to these programs therefore come from Medicaid, a county contract, the program itself, or the family.

Medicaid carries a federal duty on rides that Medicare does not. CMS describes the transportation assurance as a duty to make sure beneficiaries who have no other way to travel can reach covered care, and says states must consider a beneficiary’s behavioral health needs in picking the type of ride. For a full-benefit dual eligible, CMS says the state must ensure necessary transportation to a Medicaid-coverable service even when Medicare is the primary payer for it. Whether a given Medicaid program or plan covers a PHP or IOP is a coverage question for the program and the plan.

When a program buys the rides itself, the ride company is a vendor to the program, with a contract, a price per leg, and rules for cancellations. The facility contracts guide covers how to win and price that kind of work.

What does a county contract for day treatment rides ask for?

One public example shows what a payer expects from a vendor that carries riders to day treatment and partial hospitalization every weekday. In December 2025 the Hamilton County, Ohio, Department of Job and Family Services issued request for proposals KB05-25R for non-emergency rides for Medicaid adults and group rides for Medicaid minors. Its group trips go to day treatment and partial hospitalization programs. These terms are for children in groups, so adult programs will differ, but they are a useful benchmark:

Volume. From February 2024 through September 2025 the county counted 254,835 scheduled one-way group trips for minors to day treatment and partial hospitalization services.
No-shows. The county reports a 44% no-show and cancellation rate for that population, and about one third for adult trips. Its funding does not reimburse a trip that is canceled or missed. At 44%, 100 scheduled trips produce 56 completed ones, and the other 44 are not reimbursed, so the price has to cover them.
Days and hours. Group trips run Monday through Friday. The earliest and latest program times are 7:30 AM and 6:30 PM.
Return and will-call timing. A return pickup must come no later than 20 minutes after the scheduled return time. An unscheduled will-call may take no more than 60 minutes from the first call to the vehicle’s arrival.
Notice. Riders are requested by monthly requisition or at least five business days ahead.
Vehicles and riders. No subcontractors for group trips, no mixing county riders with other riders, and a camera with a 360 degree view in every vehicle, with video kept at least 48 hours.
Reports. The vendor reports the no-show percentage weekly or monthly by program location and tells the county when a rider has three or more no-shows in a week. A critical incident means a phone call within one hour and a written report within 24 hours.
Term. Two years, with two optional two-year renewals, and the vendor proposes prices for the renewal terms up front.

The county also notes that children in these programs often need de-escalation before boarding and that behavior can escalate on the way, so drivers and monitors need age-appropriate redirection skills. Use the list as a checklist when a program or county gives you a contract: ask for the no-show rule, the return window, and who gets the incident call before you quote.

When the group runs long, riders miss days, or a rider is in crisis

Hold the return as a will-call and report patterns quickly. A program day is a block, not an appointment time, so a driver cannot count on the end. A will-call return lets the program release riders when the last group ends, and the contract’s return window sets how long the van has. For a program that ends at a fixed time each day, a scheduled return with a 20 minute window, like the county’s, is also reasonable.

Missing days need handling too. The CMS limits on cutting off a rider over no-shows apply to program riders as they do to methadone riders, so report the pattern and keep the rides available. The program may know why a rider stopped attending, so tell it early instead of waiting for the payer to notice.

Privacy when the program treats substance use

Treat the destination as private on every PHP or IOP trip, and expect extra rules when the program treats substance use. Part 2, the federal rule on substance use treatment records, covers federally assisted programs, and taking part in Medicare counts as federal assistance (42 CFR 2.12(b)). A program that treats substance use may ask a ride company to sign a qualified service organization agreement before it shares rider names. The agreement, and the limits on paying for referrals, are in the guide to rehab center transportation contracts. Keep the manifest plain and show the driver only what the trip needs.

Running program days in HealthRide

In HealthRide, a rider’s program days are set up once and the trips keep being created on their own, so a five-day program does not need to be rebooked each week. A flexible return stays on the board until the program says the group is done. Cancellations and no-shows are recorded with the wait time, which gives you a record to show a program or a payer. See recurring trips for how a series is built.

Partial hospitalization program transportation: daily rides to PHP and IOP