CMS clarified in the Calendar Year (CY) 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule that Medicare covers partial hospitalization program (PHP) services for the treatment of substance use disorders (SUDs). Specifically, notwithstanding the requirement that PHP services are provided in lieu of inpatient hospitalization, CMS considers services for the treatment of SUD and behavioral health to be consistent with the statutory and regulatory definitions of PHP services.
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