Types of Rehab Programs: Inpatient, Outpatient, PHP & IOP Explained

Addiction treatment isn’t one-size-fits-all. Treatment programs exist on a continuum from most intensive (24/7 inpatient care) to least intensive (weekly outpatient therapy). Understanding the different types of rehab programs — their structure, duration, costs, and appropriate use — helps you make informed decisions about which level of care is right for your specific situation.

The Continuum of Care

Addiction treatment is organized by level of care, with each level providing different intensity of services:

Level of Care	Hours Per Week	Where You Sleep	Cost (30 days, no insurance)	Best For
Inpatient/Residential	24/7 (168 hours)	At facility	$15,000 – $50,000	Severe addiction, unsafe home, high medical risk
Partial Hospitalization (PHP)	30-40 hours	At home	$6,000 – $20,000	Step-down from inpatient, intensive need with stable housing
Intensive Outpatient (IOP)	9-15 hours	At home	$3,000 – $10,000	Moderate addiction, work/family obligations
Standard Outpatient	1-3 hours	At home	$400 – $800	Maintenance after higher levels, mild addiction

The American Society of Addiction Medicine (ASAM) provides standardized criteria for determining which level of care is medically appropriate based on assessment across six dimensions.

Inpatient/Residential Treatment

Inpatient treatment, also called residential treatment, provides the most intensive level of care with 24/7 medical and clinical supervision in a residential facility.

What Inpatient Treatment Includes

Housing: You live at the facility for the duration of treatment, typically in shared or private rooms.

Medical supervision: 24/7 nursing care with physician oversight. Essential for medically supervised detox and managing withdrawal.

Individual therapy: Multiple sessions per week with licensed therapists (LCSWs, LPCs, psychologists).

Group therapy: Daily group therapy sessions, typically 1-3 groups per day.

Medication-assisted treatment (MAT): For opioid, alcohol, or other appropriate substance use disorders.

Evidence-based therapies: Cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, contingency management.

Meals and nutrition: Three meals daily, often with nutritional counseling.

Life skills training: Relapse prevention, coping skills, stress management, communication skills.

Family therapy: Many programs include family sessions (in-person or virtual).

Recreational activities: Exercise, meditation, art therapy, outdoor activities (varies by facility).

Discharge planning: Coordination of step-down care, aftercare planning, recovery support.

When Inpatient Treatment Is Appropriate

ASAM criteria indicate inpatient treatment when:

Severe withdrawal risk: Substances like alcohol, benzodiazepines, or fentanyl with dangerous withdrawal requiring intensive medical management.

Severe substance use disorder: Daily use, high doses, inability to abstain without 24/7 support.

Co-occurring conditions: Severe depression, suicidal ideation, psychosis, or other mental health conditions requiring psychiatric monitoring.

Unsafe environment: Homelessness, domestic violence, or living situations that would undermine recovery.

Multiple failed attempts: Previous unsuccessful treatment at lower levels of care.

Medical complications: Health conditions related to substance use requiring monitoring.

No support system: Lack of family or community support for outpatient treatment.

Inpatient Treatment Duration

30 days: Standard minimum, most common insurance authorization length

• Best for: First treatment attempt, moderate-severe SUD, good family support
• Outcomes: Establishes foundation but often insufficient alone

60 days: Extended residential care

• Best for: Severe SUD, co-occurring conditions, previous failed 30-day programs
• Outcomes: Better stabilization, more skill development

90+ days: Long-term residential

• Best for: Very severe SUD, multiple failed treatments, complex trauma, minimal external support
• Outcomes: Research shows significantly better long-term outcomes than shorter programs

NIDA recommendation: The National Institute on Drug Abuse research consistently shows 90 days or longer produces best outcomes, though 30-day programs remain most common due to insurance practices.

Inpatient Treatment Costs

Without insurance:

• 30 days: $15,000 – $50,000
• 60 days: $30,000 – $100,000
• 90 days: $45,000 – $150,000

With insurance (PPO plans like Aetna, Cigna, UnitedHealthcare):

• 30 days: $6,000 – $22,000 out-of-pocket
• 60-90 days: Often reaches out-of-pocket maximum ($7,000-$9,500), then $0

With Medicaid (Molina or state plans):

• Any duration: Typically $0 – $100

Luxury/Executive facilities:

• 30 days: $30,000 – $100,000+
• Private rooms, resort amenities, gourmet meals, holistic therapies
• Insurance may cover standard rate, you pay difference

Learn more about how much rehab costs.

Partial Hospitalization Program (PHP)

PHP, also called day treatment, provides intensive treatment while allowing you to return home each evening.

What PHP Includes

Treatment hours: 6+ hours per day, 5-7 days per week (30-40 hours weekly)

Location: Hospital-based or freestanding treatment center

Schedule: Typically 9am-3pm or 10am-4pm, Monday-Friday (some programs 7 days)

Services:

• Group therapy (primary treatment modality)
• Individual therapy (1-2 sessions weekly)
• Medication management
• Psychiatric services for co-occurring conditions
• Case management
• Family therapy (some programs)
• Skills groups (DBT, CBT, relapse prevention)

Meals: Many programs provide lunch

Medical monitoring: Daily vitals, nursing assessment, physician oversight

Drug testing: Regular urine drug screens

When PHP Is Appropriate

Step-down from inpatient: Most common use — transitioning from 24/7 care but still needing intensive support.

Primary treatment: When you need intensive care but have:

• Stable, safe housing
• Supportive family or roommates
• Transportation to/from program
• Low immediate relapse risk if not under 24/7 supervision

Medical monitoring needs: Conditions requiring frequent medical oversight but not constant supervision.

Too intensive for IOP: More serious than what IOP can address but don’t need residential.

PHP Duration

Typical length: 2-4 weeks

Progression: PHP → IOP → Outpatient (standard step-down)

Insurance authorization: Usually 1-2 weeks initially, extended with concurrent review

PHP Costs

Without insurance:

• Per day: $200 – $650
• Per week (5 days): $1,000 – $3,250
• 30 days (6 weeks at 5 days/week): $6,000 – $20,000

With insurance:

• Per day: $75 – $350 out-of-pocket
• 30 days: $2,500 – $10,000 out-of-pocket

With Medicaid:

• Per day: $0 – $10
• 30 days: $0 – $50

Intensive Outpatient Program (IOP)

IOP provides structured treatment while allowing you to maintain work, school, or family responsibilities.

What IOP Includes

Treatment hours: 9-15 hours per week, typically 3-5 days

Schedule examples:

• Monday/Wednesday/Friday, 6pm-9pm (9 hours/week)
• Monday-Thursday, 6pm-9pm (12 hours/week)
• Tuesday/Thursday, 9am-3pm (12 hours/week)

Services:

• Group therapy (primary modality) — 2-3 hours per session
• Individual therapy — 1 session weekly
• Drug testing — 1-2 times weekly
• Medication management (if on MAT)
• Case management and care coordination
• Family sessions (some programs)
• Skills training groups

Setting: You attend sessions at treatment center but live at home

When IOP Is Appropriate

Step-down from PHP: After stabilizing in more intensive care

Primary treatment: When you have:

• Moderate substance use disorder
• Stable housing and support system
• Employment or school that can accommodate modified schedule
• Motivation and engagement in treatment
• Low risk of severe withdrawal
• Transportation to/from program

Maintenance: After completing inpatient or PHP, to maintain gains

Work/family obligations: Can’t take time off for residential treatment

IOP Duration

Typical length: 8-12 weeks (some programs 16+ weeks)

Frequency: Often starts at 4-5 days/week, reduces to 3 days as you progress

Progression: IOP → Standard Outpatient (1-2 sessions weekly)

IOP Costs

Without insurance:

• Per session (3 hours): $100 – $350
• Per week (3 sessions): $300 – $1,050
• Monthly (12 sessions): $3,000 – $10,000

With insurance:

• Per session: $30 – $150 out-of-pocket
• Monthly: $1,200 – $5,000 out-of-pocket

With Medicaid:

• Per session: $0 – $5
• Monthly: $0 – $30

Standard Outpatient Treatment

Standard outpatient provides ongoing support with the least intensive structure.

What Outpatient Includes

Treatment hours: 1-3 hours per week, typically 1-2 sessions

Schedule examples:

• One individual therapy session weekly (50-60 minutes)
• One group therapy session weekly (90 minutes)
• Combination of individual + group

Services:

• Individual therapy with licensed therapist
• Group therapy (sometimes)
• Medication management for MAT or psychiatric medications
• Periodic drug testing
• Care coordination as needed

Setting: Outpatient clinic, private practice, community mental health center

When Outpatient Is Appropriate

Maintenance after higher levels: Most common use — ongoing support after completing IOP

Mild substance use disorder: Early-stage addiction with good insight and motivation

Strong recovery supports: Active in 12-step or other peer support, strong family involvement

Sustained abstinence: Several weeks or months of abstinence established

Low relapse risk: Good coping skills, stable life circumstances

Outpatient Duration

Typical length: Months to years — ongoing as needed

Frequency: Weekly initially, may reduce to biweekly or monthly as stability increases

Lifelong support: Many individuals maintain periodic therapy long-term as relapse prevention

Outpatient Costs

Without insurance:

• Individual therapy: $100 – $200 per session
• Group therapy: $40 – $100 per session
• Monthly (4 individual sessions): $400 – $800

With insurance:

• Individual therapy: $30 – $75 copay
• Group therapy: $15 – $40 copay
• Monthly: $120 – $300

With Medicaid:

• Individual therapy: $0 – $5 copay
• Group therapy: $0 – $3 copay
• Monthly: $0 – $20

Medication-Assisted Treatment (MAT)

MAT combines FDA-approved medications with behavioral therapy. While not technically a separate “level of care,” MAT is integrated into all levels and deserves specific attention.

MAT for Opioid Use Disorder

Medications:

• Buprenorphine (Suboxone, Sublocade) — Most common, available in office-based settings
• Methadone — Dispensed daily at opioid treatment programs (OTPs)
• Naltrexone (Vivitrol) — Monthly injection, requires complete detox first

Settings: Can be provided at any level of care (inpatient through outpatient) and continued indefinitely

Effectiveness: Research shows MAT reduces overdose deaths by 50% and dramatically improves treatment retention

Cost without insurance:

• Buprenorphine generic: $150-$350/month
• Suboxone brand: $400-$600/month
• Methadone (OTP): $300-$500/month
• Vivitrol injection: $1,200-$1,500/month

Cost with insurance: $10-$250/month depending on medication and plan

Learn more: Opioid rehab cost, Heroin treatment, Fentanyl treatment

MAT for Alcohol Use Disorder

Medications:

• Naltrexone — Reduces cravings, blocks rewarding effects
• Acamprosate (Campral) — Helps maintain abstinence
• Disulfiram (Antabuse) — Creates aversive reaction to alcohol

Settings: Prescribed in outpatient settings, initiated during inpatient care

Cost with insurance: $10-$200/month

Learn more: Alcohol rehab cost

ASAM Criteria: How Level of Care Is Determined

The American Society of Addiction Medicine (ASAM) provides standardized criteria used by treatment professionals and insurance companies to determine appropriate level of care.

Six Dimensions Assessed

Dimension 1: Acute Intoxication and Withdrawal Potential

• Current intoxication level
• History of withdrawal
• Risk of severe or complicated withdrawal
• Medical monitoring needs

Example: Benzodiazepine or alcohol withdrawal risk indicates need for medical detox/inpatient.

Dimension 2: Biomedical Conditions and Complications

• Co-occurring medical conditions
• Pregnancy
• Chronic pain
• Need for medical monitoring

Example: Diabetes requiring insulin management may need higher level for monitoring.

Dimension 3: Emotional, Behavioral, or Cognitive Conditions

• Mental health diagnoses
• Suicide risk
• Cognitive impairment
• Emotional stability

Example: Active suicidal ideation requires inpatient psychiatric or dual diagnosis residential.

Dimension 4: Readiness to Change

• Motivation for treatment
• Insight into problem
• Ambivalence about change
• Stage of change (precontemplation, contemplation, preparation, action)

Example: High ambivalence may require motivational interviewing at any level.

Dimension 5: Relapse, Continued Use, or Continued Problem Potential

• Severity of addiction
• Cravings intensity
• Previous relapse patterns
• Impulsivity
• Coping skills

Example: High relapse risk indicates need for structured environment (inpatient or PHP).

Dimension 6: Recovery Environment

• Living situation safety
• Family support or sabotage
• Access to substances at home
• Work/school stability
• Social network (supportive vs. using peers)

Example: Homelessness or living with active users indicates need for residential treatment.

ASAM Level of Care Placement

Based on these six dimensions, ASAM recommends specific levels:

• Level 0.5: Early intervention
• Level 1: Outpatient services
• Level 2.1: Intensive outpatient (IOP)
• Level 2.5: Partial hospitalization (PHP)
• Level 3.1: Clinically managed low-intensity residential
• Level 3.3: Clinically managed population-specific high-intensity residential
• Level 3.5: Clinically managed high-intensity residential
• Level 3.7: Medically monitored intensive inpatient
• Level 4: Medically managed intensive inpatient

Insurance companies use ASAM criteria for preauthorization decisions.

The Step-Down Approach

Best-practice addiction treatment uses a step-down model, progressing through decreasing intensity as you stabilize:

Typical Step-Down Progression

Week 1-4: Inpatient/Residential

• Medical detox (days 1-7)
• Stabilization and intensive therapy
• Foundation building
• $15,000-$50,000 self-pay; $6,000-$22,000 with insurance

Week 5-8: Partial Hospitalization (PHP)

• 6+ hours daily treatment
• Transition to living at home
• Continued intensive support
• $6,000-$20,000 for 4 weeks self-pay

Week 9-20: Intensive Outpatient (IOP)

• 9-15 hours weekly
• Return to work/school with modified schedule
• Build independent coping skills
• $9,000-$30,000 for 12 weeks self-pay

Month 6+: Standard Outpatient

• 1-2 sessions weekly
• Maintenance and relapse prevention
• Ongoing support
• $400-$800 monthly self-pay

Ongoing: MAT (if appropriate)

• Continued medication management
• Protects against relapse and overdose

Benefits of Step-Down Model

Clinical benefits:

• Provides appropriate intensity at each stage
• Builds independence gradually
• Maintains therapeutic gains
• Reduces relapse risk

Financial benefits:

• More cost-effective than extended inpatient
• Insurance more likely to authorize step-down
• Out-of-pocket maximum may cover multiple levels

Practical benefits:

• Return to work/life responsibilities gradually
• Maintain housing and employment
• Build recovery community connections

Specialized Treatment Programs

Beyond standard levels of care, specialized programs serve specific populations:

Dual Diagnosis Programs

What: Integrated treatment for substance use disorder + mental health conditions

When appropriate: Depression, anxiety, PTSD, bipolar disorder, schizophrenia co-occurring with addiction

Availability: All levels of care (inpatient through outpatient)

Cost impact: Typically 10-20% more than standard treatment

Gender-Specific Programs

What: Women-only or men-only treatment addressing gender-specific issues

Women’s programs: Trauma-informed care, parenting support, reproductive health

Men’s programs: Masculinity issues, anger management, fatherhood

Adolescent/Young Adult Programs

What: Age-appropriate treatment for teens and young adults (13-25)

Focus: Development stage considerations, family involvement, education coordination

Settings: Residential schools, wilderness programs, traditional inpatient with adolescent tracks

Executive/Professional Programs

What: Treatment for professionals with accommodations for work obligations

Features: Private rooms, business amenities, flexible schedules, confidentiality emphasis

Cost: $40,000-$100,000+ for 30 days

LGBTQ+ Programs

What: Culturally competent care for LGBTQ+ individuals

Focus: Identity issues, minority stress, trauma, family dynamics

Choosing the Right Program

Selecting the appropriate type and level of rehab involves:

1. Clinical Assessment

Professional evaluation using ASAM criteria determines medically appropriate level of care.

2. Insurance Verification

Check what your plan covers:

• Does insurance cover rehab?
• Carrier-specific: Aetna, Cigna, UnitedHealthcare, Blue Cross Blue Shield, Humana, Kaiser

3. Facility Research

• Accreditation (Joint Commission, CARF)
• Evidence-based practices
• Staff credentials
• Success metrics
• Reviews and reputation

4. Cost Analysis

Calculate your out-of-pocket costs:

• How much does rehab cost?
• Use cost calculator

5. Practical Considerations

• Location (local vs. out-of-state)
• Family involvement options
• Work/school accommodations
• Childcare needs

Common Questions

“Can I start with outpatient and go to inpatient if needed?”

Yes, though starting at appropriate level based on ASAM assessment produces better outcomes. “Failing” at lower levels wastes time and risks relapse/overdose.

“Will insurance cover 90 days?”

Insurance typically authorizes 7-14 days initially, then conducts concurrent reviews. If clinically appropriate and you’re making progress, 60-90 days can be authorized, though you may need to step down through PHP/IOP rather than staying inpatient entire time.

“Is inpatient always better than outpatient?”

No. More intensive isn’t always better if not clinically indicated. IOP with strong support system can be as effective as inpatient for moderate SUD. Match intensity to clinical need.

“Can I work during PHP or IOP?”

IOP yes, with modified schedule (evening programs common). PHP is more difficult due to 6+ hour daily commitment.

Sources

• American Society of Addiction Medicine (ASAM). “ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions.” 2024.
• National Institute on Drug Abuse (NIDA). “Principles of Drug Addiction Treatment.” 2024.
• Substance Abuse and Mental Health Services Administration (SAMHSA). “Treatment Episode Data Set (TEDS).” 2024.
• Healthcare.gov. “Mental Health and Substance Use Disorder Coverage.” 2026.