Definitions for levels of care

Priority Health recognizes the following distinct levels of care.

Psychiatric disorder levels of care

  • Acute inpatient: The highest intensity of medical and nursing services provided within a structured environment providing 24-hour skilled nursing and medical care. Full and immediate access to ancillary medical care must be available for those programs not housed within general medical centers.
  • Residential treatment: Care provided at a 24-hour, state-licensed sub-acute level with licensed health care professionals. Read the medical policies for adult residential care and child/adolescent residential care for the complete definitions.
  • Partial hospital: An intensive non-residential level of service where multidisciplinary medical and nursing services are required. This care is provided in a structured setting, similar in intensity to inpatient, meeting for more than 4 hours (and, generally, less than 8 hours) daily.
  • Intensive outpatient: Multidisciplinary, structured services provided at a greater frequency and intensity than routine outpatient treatment. These are generally up to 4 hours per day, up to 5 days per week. Common treatment modalities include individual, family, and group psychotherapy and medication management.
  • Outpatient: The least intensive level of service, provided in an office setting. Individual psychotherapy sessions last for up to 60 minutes per day and group psychotherapy sessions for up to 90 minutes per day.

Substance use disorder levels of care

  • Inpatient detoxification: Detoxification services provided in an inpatient setting with full skilled nursing and medical care. Generally, services are provided on inpatient or sub-acute units. They can also be provided on a medical/surgical unit or other medical hospital unit when needed for safety or in the absence of adequate services elsewhere.
  • Inpatient rehabilitation: Care provided at an inpatient facility or sub-acute level with skilled nursing care after a patient has fully or partially recovered from acute detoxification symptoms and no longer requires intensive medical monitoring. These services can be provided in intermediate care facilities (ICFs) or have other licensing designations that may vary by state.
  • Residential treatment: Care provided at a 24-hour, state-licensed sub-acute level with licensed health care professionals. Read the medical policies for adult residential care and child/adolescent residential care for the complete definitions.
  • Outpatient/ambulatory detoxification: Detoxification services delivered within a structured program having medical and nursing supervision where physiological consequences of substance withdrawal do not have life-threatening potential. 
  • Partial hospital: An intensive, non-residential level of care where multidisciplinary medical and nursing services are required. This care is provided in a structured setting, similar in intensity to an inpatient setting, meeting for more than four hours (and, generally, less than 8 hours) daily. Such care is appropriate for substance use disorder treatment when provided in conjunction with ambulatory detoxification or when medical co-morbidity or other complications make less intensive levels of care unsafe or inadequate. 
  • Intensive outpatient: Multidisciplinary, structured services provided at a frequency of up to 4 hours daily, up to 5 days per week, for the treatment of a substance use disorder. 
  • Outpatient: The least intensive level of service, provided in an office setting. Individual psychotherapy sessions occur for up to 60 minutes per day and group psychotherapy sessions for up to 90 minutes per day. 
Last modified: 9/15/2016
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