Cost and coverage

What treatment costs, honestly.

There is no single price for an outpatient program, and anyone who quotes you one without seeing your plan is guessing. Here is what actually sets the number, and how to work out yours.

Check what my plan covers (303) 219-0973

Straight answer

No one can quote you a real price yet.

Three things set what you pay: which level of care you need, how long you need it, and what your particular plan has already paid out this year. None of the three is knowable from a web page.

That is arithmetic, not evasion. The field measures outpatient levels in treatment hours per week: an intensive outpatient program runs nine or more hours of structured treatment a week, and a partial hospitalization program twenty or more. Both sit at Level II of the continuum of care, between weekly therapy and residential treatment. A program running more than twice the hours bills more than twice before a single insurance rule is applied. So the first thing that moves your number is not a price list. It is which level of care the assessment says you need.

The second thing is your plan, and that is where most of the variation actually lives. Two people can start the same program on the same day and owe very different amounts, because one has met their deductible for the year and the other has not. Same care, same hours, same billing, different math.

What we can do is the part that is knowable. The Redpoint Center checks your benefits with your insurer at no cost, before you commit to anything, and explains what we find in plain language. The rest of this page is what we would walk you through on that call, written down so you can make a start on it without us.

The six variables

What actually moves the number.

Every one of these changes what you pay, and not one of them is a price. This is also the vocabulary your insurer will use when you call them, so it is worth having straight beforehand.

Level of care

PHP runs 20 or more treatment hours a week, IOP nine or more, and outpatient less again. More hours delivered means a larger total billed before insurance is applied.

Length of stay

Treatment length is individualized rather than set by a calendar. Your care team reviews progress and steps you down when you are ready, so the total is not fixed on day one.

Your deductible

What you pay yourself before the plan starts paying its share. It resets each year, so where you are in that year matters as much as which program you choose.

Your coinsurance

After the deductible, most plans split the bill rather than covering it. Coinsurance is your percentage of that split. Some plans use a flat copay per visit instead.

Out-of-pocket maximum

The annual ceiling on what you can be asked to pay. Once you reach it, the plan covers the rest. On a program running several days a week, this is often the number that decides your real total.

Network status

Whether a provider is in network with your plan changes the rate and your share of it. Out-of-network benefits still exist on many plans and are worth checking rather than assuming.

Run your own numbers

Four numbers, and you can estimate this yourself.

Everything here is on your insurance card or your plan's summary of benefits. Nobody needs our permission to look them up, and having them in front of you makes the benefits call a great deal shorter.

Have us do this with you
  1. 1

    Find your deductible, and whether you have met it

    On your card or plan summary

    The amount you pay yourself before the plan starts paying its share. It resets every year. If you have already had a surgery, a hospital stay, or a course of treatment this year, you may be far closer to it than you assume, and that moves your number more than the choice of program does.

  2. 2

    Find your coinsurance

    After the deductible is met, most plans split the bill with you rather than covering all of it, and coinsurance is your percentage of that split. Some plans charge a flat copay per visit instead, which is easier to predict. Worth confirming which of the two you have, because they behave very differently over a program that runs for weeks.

  3. 3

    Find your out-of-pocket maximum

    Usually the number that matters most

    This is the ceiling, and it is the one people miss. Once your spending for the year reaches it, the plan covers everything after that. For treatment running several days a week, the question is often not what each week costs but how quickly you reach that ceiling and stop paying.

  4. 4

    Match it to the level of care

    Then apply the hours. Partial hospitalization bills more than intensive outpatient because it runs more than twice the treatment hours in a week. Which level you need is set by a clinical assessment rather than by you, and it can step down as you improve, which lowers the running cost as it goes.

Three kinds of coverage

Commercial plans, Health First Colorado, and TRICARE.

Most people who call are on a commercial plan through an employer or the state marketplace. Redpoint works with Aetna, Anthem Blue Cross Blue Shield, Carelon Behavioral Health, Cigna, First Health Network, Kaiser Permanente, Rocky Mountain Health Plans, Select Health, TRICARE, and United Healthcare. A plan that is not on that list is not automatically a dead end, since out-of-network benefits are worth checking too. Either way you can have us check your specific plan before you decide anything.

If you are on Health First Colorado, the state Medicaid program, the useful detail is that the covered benefit names these two levels specifically. The state's outpatient behavioral health page describes intensive outpatient programs at 9 to 19 hours of treatment a week for adults, and partial hospitalization programs at 20 or more, which is the same way the rest of the field divides them. Colorado also uses American Society of Addiction Medicine criteria to determine level of care placement, and makes behavioral health services available without a referral or copay. Redpoint can accept some Colorado Medicaid policies, and which ones depends on your specific plan, so call us or submit the verification form and we will tell you where you stand.

If you are covered by TRICARE, intensive outpatient care is a covered benefit rather than an exception granted case by case. A 2016 federal rule expanded TRICARE to cover intensive outpatient programs and opioid use disorder treatment, and aligned what beneficiaries pay for mental health and substance use care with what they pay for medical and surgical care. Older material describing intensive outpatient as outside the TRICARE benefit predates that change, so if that is what your search turned up, it is out of date. How your particular plan handles referrals and authorization is still worth confirming, and the benefits check is the fastest route to it.

We will make the call for you

An Admissions Coordinator confirms your behavioral health benefits directly with your insurer, then explains what they found in plain language rather than plan language. All assessments are free, it takes one form or one phone call, and it does not commit you to starting anything.

Verify Your Insurance (303) 219-0973

Accepted insurance

Employer and EAP partners

Don’t see your plan? Call us and we will check it, including out-of-network benefits.

No insurance

What to ask when you are paying yourself.

What Redpoint can do depends on your situation, so that part is a phone call. These are the routes SAMHSA tells people to raise with any provider, and they are worth asking about everywhere you call, not only here.

Ask about a sliding-fee scale

Some providers set the price against your income. SAMHSA suggests asking directly when you call to book, because it is not always advertised.

Ask about a payment plan

Programs attached to larger centers or hospitals sometimes let you spread the cost over time rather than settling it at intake.

Ask about grants or charity care

Some programs hold grants, scholarships, or charity care funds for people who cannot pay. They are usually limited and rarely posted publicly, so asking is the only way to find them.

Check whether your employer runs an EAP

An Employee Assistance Program is a free, confidential benefit your employer already pays for. Worth asking human resources about even if you do not plan to use their health insurance.

Call the Behavioral Health Administration

SAMHSA points people without insurance to their state behavioral health agency. In Colorado that is the BHA, and it can tell you how to get treatment without coverage.

Call the national helpline

SAMHSA runs a free, confidential helpline at 1-800-662-4357, staffed day and night, that can refer you to treatment regardless of what coverage you have.

Before you call

The questions people actually ask.

How much does IOP or PHP cost in Colorado?
There is no single price, and any number quoted without seeing your plan is a guess. What you pay is set by three things: the level of care you need, how long you need it, and what your insurance has already paid out this year. A partial hospitalization program bills more than an intensive outpatient program because it runs more than twice the treatment hours per week, but that gap can disappear entirely once a deductible is met or an out-of-pocket maximum is reached. The Redpoint Center checks your benefits at no cost and tells you what your plan actually does for the program you are considering.

Does insurance cover IOP and PHP?
Most major plans cover both, though the terms can differ between the two levels. Redpoint works with Aetna, Anthem Blue Cross Blue Shield, Carelon Behavioral Health, Cigna, First Health Network, Kaiser Permanente, Rocky Mountain Health Plans, Select Health, TRICARE, and United Healthcare. A plan can approve one level readily and ask more questions about the other, which is why a benefits check is run against a specific program rather than against treatment in general. You can verify your insurance online or call (303) 219-0973.

Why does PHP cost more than IOP?
Because it is more hours, not because it is better care. Under the level-of-care standards used across the field, partial hospitalization runs 20 or more treatment hours a week and intensive outpatient runs nine or more, so more is delivered and more is billed. It does not follow that PHP is the stronger choice. The right level is the one your clinical need calls for, and more structure than you need is not an upgrade you are paying to receive.

What is the difference between a deductible and an out-of-pocket maximum?
Your deductible is where the plan starts helping, and your out-of-pocket maximum is where it takes over completely. You pay costs yourself until you reach the deductible, then you and the plan share them, usually through coinsurance. Once your total spending for the year hits the out-of-pocket maximum, the plan covers everything beyond it. For treatment running several days a week over several weeks, the out-of-pocket maximum is often what determines your real total, and it is the number people most often forget to look up.

Does Health First Colorado cover intensive outpatient or partial hospitalization?
Yes, both sit inside the covered benefit. Colorado's outpatient behavioral health page describes intensive outpatient programs at 9 to 19 hours of treatment a week for adults, and partial hospitalization programs at 20 or more. The state also uses American Society of Addiction Medicine criteria to determine level of care placement, and makes behavioral health services available without a referral or copay. Redpoint can accept some Colorado Medicaid policies, and which ones depends on your specific plan, so call us or submit an insurance verification form to find out more about your coverage.

Does TRICARE cover intensive outpatient treatment?
Yes. A federal rule finalized in 2016 expanded TRICARE to cover intensive outpatient programs and opioid use disorder treatment, and brought cost sharing for mental health and substance use care in line with medical and surgical care. If you have read older guidance saying intensive outpatient falls outside the TRICARE benefit, it predates that change. Redpoint accepts TRICARE, and a benefits check will confirm how your particular plan handles referrals and authorization.

What if I do not have insurance?
Call and ask, and ask everywhere else you are calling too. SAMHSA lists several routes worth raising with any provider: a sliding-fee scale, a payment plan, or grants, scholarships, and charity care. SAMHSA also suggests asking your employer whether they run an Employee Assistance Program, a free and confidential service your company pays for, and calling 1-800-662-4357 any time day or night. What Redpoint can do depends on your circumstances, which makes it a conversation rather than a web page.

Will I know what I owe before I start?
That is the entire point of the benefits check. An Admissions Coordinator confirms your behavioral health benefits with your insurer, then explains what your plan covers for the specific program you are considering, in plain terms. Nothing is scheduled and nothing is charged while that happens. Plenty of people verify, take the information away, and decide in their own time.

Does the length of treatment change what I pay?
Yes, and treatment length is individualized rather than fixed at intake. Your care team reviews your progress regularly and steps you down to a lighter level when you are ready, so the total follows a clinical judgment made as you go rather than a number set on the first day. Stepping down is the normal path: partial hospitalization into intensive outpatient, intensive outpatient into outpatient care, then alumni support.
Still want a real number? Call (303) 219-0973

Levels of care

What you would be paying for.

Cost tracks the level of care, so these are the programs the number attaches to, from the most structured to the least intensive.

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PHP

Partial Hospitalization (PHP)

Our most structured outpatient level, several hours a day, for early recovery or when more support is needed.

Learn more
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IOP

Intensive Outpatient (IOP)

Structured group and individual therapy several times a week, built to fit around work and family.

Learn more
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OP

Outpatient (OP)

Lighter-touch weekly therapy for step-down and continuing care as you return to your routine.

Learn more
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Virtual

Virtual IOP

The full IOP structure delivered by telehealth, with the same clinical rigor, anywhere in Colorado.

Learn more
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Housing

Sober Living

Supportive, structured housing that reinforces recovery skills as you step back into daily life.

Learn more

Let's get you a real number.

One call and an Admissions Coordinator can check your benefits with your insurer, tell you what your plan covers for the program you are considering, and answer the questions a page like this one cannot. Free, confidential, and no obligation to start.

(303) 219-0973

Or text us at (970) 475-8646

We accept most major insurance plans and our team will help verify your coverage at no cost.