IOP and PHP schedule templates: day and evening weeks that meet payer hours

We run a licensed Texas outpatient program (PHP, IOP and outpatient) and built our own EHR around it. The schedule is the first thing a payer, a surveyor and a new counselor ask to see, and the most common way a program loses money without noticing: a week that looks full on the wall but doesn't add up to billable hours in the chart. The templates below come from the program description we write for clients in our IOP / PHP Program Launch, with the minutes added up.

How many hours: the benchmarks

There isn't one national rule. The hours come from four places, and the strictest one that applies to a client is the one you build for.

Source	PHP	IOP	What to know
The ASAM Criteria (substance use)	Level 2.5: 20 or more hours a week	Level 2.1: 9 or more hours a week for adults (6 for adolescents)	The 4th edition renames level 2.5 "high-intensity outpatient"; most payers and state rules still say PHP. Use the edition your payers require.
SAMHSA TIP 47	Daily programming of about 6 hours should be considered partial hospitalization	Traditionally at least 9 hours a week, usually three 3-hour sessions; the panel's range was 6 to 30 contact hours	The federal treatment protocol for designing an IOP. Hours should follow client needs.
Medicare (CY 2024 outpatient rule)	Physician certifies a need for at least 20 hours a week	Physician certifies a need for at least 9 hours a week	Only for hospitals, community mental health centers and a few other provider types. Most freestanding programs can't bill Medicare for these levels.
Your contracts	Set by each plan	Set by each plan	Often a daily minimum as well as a weekly one, and often only time in services by qualified staff. This is the rule that decides whether a day is paid.

Our EHR ships with the defaults most contracts use (PHP 4 hours a day and 20 a week; IOP 3 hours a day and 9 a week), and every program edits them to match its contracts. Write each payer's numbers into your program description; where payers differ, the strictest one sets the schedule.

What counts toward the hours

Activity	Usually counts?	Why
Group therapy and skills or education groups	Yes	The core service. Each client's note needs actual start and end times.
Individual therapy on a program day	Depends on the contract	Some payers count it toward the day; others treat it as part of the per diem but not the hours, or pay it separately.
Psychiatric visit or case management	Depends on the contract	Ask in writing. Don't assume.
Check-in, vitals, drug screen collection	Usually no	Administrative time. Put the safety screen inside the first group instead of before it.
Breaks, lunch, transport	No	Never part of the service time. Leave them out of the totals on the published schedule.
Minutes a client missed	No	Late arrivals and early departures come off that client's hours. The note records the minutes attended.

Template 1: PHP and day IOP on one track

Sharing the morning between PHP and day IOP lets a small program run full groups and makes a step-down from PHP to IOP painless: the client keeps the same morning groups and drops the afternoon. We lengthen each morning block to 100 minutes so day IOP comes to 10 hours a week, not exactly 9.

Time	Service	Who attends	Service minutes
8:45–9:00	Arrival and check-in	Everyone	0 (not counted)
9:00–10:40	Process group, opening with a check-in that covers safety and, for substance use, cravings and use since the last session	PHP Mon–Fri; day IOP Mon, Wed, Thu	100
10:40–10:50	Break	Everyone	0
10:50–12:30	Skills group on the curriculum topic of the day	PHP Mon–Fri; day IOP Mon, Wed, Thu	100
12:30–1:10	Lunch	PHP	0
1:10–2:40	Specialty group: family systems, trauma-informed coping, wellness or relapse prevention	PHP	90
2:40–3:30	Individual sessions, case management and psychiatric visits, by appointment	PHP; day IOP by appointment	Per contract

Template 2: evening IOP for people who work

An evening track is what lets employed clients, parents and students say yes to IOP. Mon, Tue and Thu is a common pattern; it keeps a day off between most sessions and leaves Fridays free.

Time	Service	Days	Service minutes
4:30–5:50	Individual sessions and case management, by appointment	Mon, Tue, Thu	Per contract
5:50–6:00	Arrival and check-in	Mon, Tue, Thu	0
6:00–7:40	Process group with check-in and safety screen	Mon, Tue, Thu	100
7:40–7:50	Break	Mon, Tue, Thu	0
7:50–9:30	Skills group on the curriculum topic of the day	Mon, Tue, Thu	100
Sat 10:00–11:40	Optional make-up group for anyone short on hours that week	Sat	100

That's 10 hours a week, plus a make-up slot. Where the required health topics go: Texas requires every client to get education on tuberculosis, HIV, hepatitis B and C and sexually transmitted infections, and on tobacco and nicotine (26 TAC 564.901(d)–(e)). Put them on a day every track attends. In these templates that's Monday or Thursday: PHP, day IOP and evening IOP all meet then. One Thursday a month, the skills group is the health topic, so no client goes a month without it.

Template 3: outpatient step-down

Outpatient (OP) is the landing spot after IOP: fewer than 9 hours a week, often 1 to 2. A typical week is one 90-minute group (for example Wednesday 6:00–7:30 pm) and one individual session. Keep the OP group on the same curriculum rotation so a client stepping down doesn't repeat last week's topic, and time it so clients can step down without changing their work schedule again.

Template 4: adolescent day treatment (Texas)

Adolescent programs are the one place Texas licensing sets hours for outpatient care. A licensed chemical dependency facility providing adolescent day treatment must provide at least 15 hours of services a week, including at least one hour of individual counseling and 14 hours of other counseling, education, life skills and relapse prevention, and school attendance doesn't count (26 TAC 564.905(c)). Adolescents must be kept separate from adults (564.905(b)(1)).

Time	Service	Days	Service minutes
3:30–5:00	Process or counseling group	Mon–Fri	90
5:00–5:10	Break and snack	Mon–Fri	0
5:10–6:40	Education, life skills or relapse prevention group	Mon–Fri	90
By appointment	Individual counseling, at least 60 minutes a week; family sessions as planned	Weekly	60+

That's 15 hours of groups plus an hour of individual counseling: 16 hours, a one-hour cushion. If your adolescent program isn't licensed as day treatment, check which rule applies with HHSC before you set hours.

A worked week: when the hours fall short

A made-up PHP client on Template 1, scheduled for 4 hours 50 minutes a day:

Day	What happened	Hours documented	Meets a 4-hour PHP day?
Mon	All three groups	4:50	Yes
Tue	All three groups	4:50	Yes
Wed	Left at 12:00 for a court date	2:50	No
Thu	All three groups	4:50	Yes
Fri	All three groups, plus a 50-minute individual session	4:50 (5:40 if the contract counts individual time)	Yes

The week totals 22 hours 10 minutes (23 hours if individual time counts), so the weekly picture is fine. But Wednesday can't be billed as a PHP day under a contract with a 4-hour daily minimum, and it can't quietly become an IOP day either unless the contract and authorization allow it. Two lessons: count each day against the daily rule and each week against the weekly rule, and count from signed notes, not the sign-in sheet. Cima EHR's IOP and PHP plan does this on its own: each client's hours come from their signed group entries (minus any minutes they left early), and a day becomes one per diem charge only when it meets its level's hours.

Texas rules that shape the schedule

A licensed Texas chemical dependency treatment facility is surveyed against 26 TAC chapter 564. These rules touch the schedule directly:

• Group size: group counseling is limited to 16 clients; education and life skills groups to 35, except multi-family, seminar or large-audience events (564.901(b)). Two counselors in one room don't make a group of 20 legal; split it.
• Who leads what: chemical dependency counseling is provided by a qualified credentialed counselor (QCC), a graduate or a counselor intern; education and life skills can be led by counselors or people with specialized education and expertise (564.901(p)). Staff your schedule grid by credential, not just by name.
• A written curriculum for education and life skills groups, with client participation and discussion (564.901(c)).
• Both groups and individual counseling: outpatient treatment includes educational and process groups and individual counseling (564.904(d)), so every client's week needs an individual slot, even if your payer doesn't count it toward hours.
• A meal break after 5 consecutive hours of scheduled activities (564.1101(a)). It matters for long PHP days.
• Notes within 72 hours with the date, the nature and duration of the contact, the topic for groups, and the signature and credentials of the person who provided it (564.804(l)). Schedule 10 minutes after each group for facilitators to write entries while the details are fresh.
• Telehealth is allowed with conditions: verbal consent documented for each electronic service, identity checked at the start, and audio-only only for an existing clinical relationship with the reason recorded (564.911). Many payers have their own rules for video IOP, so ask before you run a virtual track.

Our summary of 26 TAC 564 was checked against the rule text in September 2026. Rules change; confirm the current text with HHSC before you rely on any detail.

Build yours in seven steps

1. List every payer's hour rules, daily and weekly, and what each counts. Ask for it in writing during contracting; our prior authorization guide covers what to ask.
2. Pick the tracks your clients need: day, evening, or both. An evening track is often what makes IOP possible for working adults.
3. Lay out blocks with a cushion of about 10% over the strictest weekly minimum.
4. Put breaks, lunch and check-in outside the counted time, and show the counted minutes on the internal version of the schedule.
5. Assign facilitators by credential (QCC, graduate or intern for counseling groups) and keep each group at 16 or fewer.
6. Attach the curriculum: a topic for every group on a rotation, with the required health topics on a day every track attends.
7. Load it into the EHR with each level's daily and weekly hours and billing code, then run a test week before the first client. That test week is the last step before opening in our program launch package. Our compliance calendar covers the recurring checks around it.

Questions

How many hours a week is an IOP?

At least 9 hours a week for adults is the common standard (ASAM level 2.1, SAMHSA's TIP 47 and Medicare's IOP certification all use it), usually 3 days of about 3 hours. Adolescent IOP under ASAM starts at 6 hours. Each payer sets its own minimum, so check the contract.

How many days a week is PHP, and for how long each day?

Usually 5 days a week, 4 to 6 hours a day, for at least 20 hours of services. Our template runs 9:00 to 3:30 with 4 hours 50 minutes of groups a day, plus individual and psychiatric visits.

Does lunch count toward PHP hours?

No. Lunch, breaks, check-in and transport aren't services. Most payers count only time in services delivered by qualified staff, and Texas requires a meal break after 5 consecutive hours of scheduled activities.

Can PHP and IOP clients be in the same group?

Commonly, yes: sharing morning groups is how many programs keep groups full and make step-downs smooth. Keep counseling groups at 16 or fewer in Texas, write each client's own note, and never mix adolescents with adults.

Does Texas set minimum hours for adult IOP or PHP?

No. 26 TAC 564 doesn't set weekly minimums for adult outpatient levels; it requires enough intensity to reach treatment plan goals. The hours come from payers and the ASAM Criteria. Texas does set 15 hours a week for adolescent day treatment.

Can an IOP be run by video?

In Texas, licensed facilities may provide services by telehealth under 26 TAC 564.911's conditions, including documented verbal consent for each electronic service. Whether a payer pays for a virtual IOP day is a separate question for each contract.

Already open and short on hours or authorizations? Our utilization review guide shows how to catch it before the payer does, or book a free 30-minute call.

Sources

• ASAM, The ASAM Criteria: asam.org
• SAMHSA, TIP 47, Substance Abuse: Clinical Issues in Intensive Outpatient Treatment: store.samhsa.gov; Advisory based on TIP 47: store.samhsa.gov
• CMS, CY 2024 outpatient final rule (IOP and PHP certification hours): Federal Register; CMS fact sheet
• 26 TAC chapter 564 (Cornell LII): chapter index, 564.804, 564.901, 564.904, 564.905, 564.911, 564.1101
• HHSC, chemical dependency treatment facilities: hhs.texas.gov