Levels of care
PHP vs IOP vs Outpatient: Choosing the Right Level of Care
Partial hospitalization, intensive outpatient, and standard outpatient care let people recover while living at home or in sober housing. The difference is how many hours a week treatment takes.
Updated
Partial hospitalization (PHP), intensive outpatient (IOP), and standard outpatient care are all ways to get serious addiction treatment without living at a facility. The main difference between them is the number of hours per week, and the right one depends on how much structure someone needs right now.
People often use them as steps: residential, then PHP, then IOP, then weekly therapy. Others start directly in IOP. Both paths are normal.
How do the levels compare?
| Partial hospitalization (PHP) | Intensive outpatient (IOP) | Outpatient | |
|---|---|---|---|
| Typical hours | 20 or more per week | 9 or more per week (adults) | Under 9 per week, often 1 to 2 |
| Typical schedule | About 5 to 6 hours a day, 5 days a week | About 3 hours a day, 3 to 5 days a week | A weekly individual or group session |
| Typical length | 2 to 6 weeks | 6 to 12 weeks | Months, as needed |
| Best for | Stepping down from residential, or needing daily structure while living at home | Early recovery alongside work, school, or family | Ongoing maintenance after more intensive care |
The hour thresholds come from the ASAM Criteria, the framework most insurers and programs use to match people to levels of care.
What happens in a PHP or IOP?
The content is similar to residential care, compressed into fewer hours:
- Group therapy on relapse prevention, coping skills, emotional regulation, and relationships
- Individual therapy, usually weekly
- Psychiatric care and medication management, including medications for alcohol and opioid use disorders
- Drug testing
- Family sessions or education
- Connection to peer support such as 12-step, SMART Recovery, or other groups
The real work happens in the hours in between. Going home each night means practicing new skills in the actual environment where cravings and stress happen, with a group to process it the next day. That’s the strength of these programs, and also the risk if home isn’t stable.
Who does each level fit?
PHP suits someone who needs daily structure and clinical attention but doesn’t need 24-hour supervision. That’s often someone stepping down from residential rehab, or someone whose mental health symptoms need close follow-up.
IOP suits someone who is medically stable, has a reasonably supportive living situation, and can stay sober between sessions most of the time. Evening IOP tracks exist specifically so people can keep working.
Standard outpatient suits people further into recovery, or those with milder substance use, who benefit from ongoing therapy without a heavy time commitment.
Virtual IOP has also grown quickly and works well for many people, especially in rural parts of Florida far from a program.
How does sober living fit in?
Many people in PHP or IOP live in a sober living home, also called a recovery residence, rather than returning straight home. A good one adds what a day program can’t: a sober household, house rules, peer accountability, and structure in the evenings.
In South Florida, pairing a PHP or IOP with sober housing is common, so much so that it’s sometimes called the “Florida model.” It can work very well. It’s also the arrangement that patient brokers exploited in the 2010s, trading free rent for insurance billing. Florida now runs a voluntary certification program for recovery residences through the Florida Association of Recovery Residences (FARR), and state law generally bars licensed treatment providers from referring patients to uncertified residences. Our guide to vetting a Florida rehab or sober home covers how to check certification and what red flags to watch for.
How do you know when to step down?
Stepping down should be a clinical decision based on how someone is doing, not just on how many days insurance approved. Signs someone is ready include:
- Stable sobriety for a meaningful stretch
- Mental health symptoms under control
- A realistic plan for triggers at home and work
- An established support network outside the program
Stepping back up is also fine. If someone starts using again during IOP, moving temporarily to PHP or residential is a normal adjustment, not a failure.
Questions to ask a PHP or IOP
- What’s the weekly schedule, and is there an evening track?
- Is there a psychiatric prescriber, and do you offer medications for alcohol and opioid use disorder?
- Do you require people to live in a particular sober home? (If yes, ask why, and check the home’s FARR certification.)
- How do you decide when someone steps up or down?
- What does aftercare look like when the program ends?
Common questions
What is the difference between PHP and IOP?
Intensity. A partial hospitalization program (PHP) typically runs about five or more hours a day, five days a week, for at least 20 hours of treatment. An intensive outpatient program (IOP) usually runs about three hours a day, three to five days a week, for at least nine hours weekly for adults.
Can I work while in an IOP?
Often, yes. Many IOPs offer evening or early morning tracks designed for people who work or go to school. PHP is harder to combine with a full-time job because of the daytime hours.
How long does intensive outpatient treatment last?
Commonly six to twelve weeks, depending on progress and insurance. Many people then continue with weekly outpatient therapy for months.
Does Medicare cover intensive outpatient programs?
Yes. Medicare began covering intensive outpatient services for mental health and substance use disorders in 2024. Private plans and Florida Medicaid also commonly cover IOP.
This guide is general information, not medical or legal advice, and Delray Recovery is not a treatment provider. For help finding care, call the SAMHSA National Helpline at 1-800-662-4357. In a crisis, call or text 988, or call 911.