What is outpatient addiction treatment?
Outpatient treatment is the most flexible level of care. You visit a clinic, counselor's office or doctor, or meet by video, then return to your daily life. Services can include individual therapy, group counseling, family therapy, medication management and drug testing.
Programs and insurers use The ASAM Criteria, placement guidelines from the American Society of Addiction Medicine (ASAM), to define levels of care. The fourth edition, published in 2023, splits outpatient care into three levels:
- Level 1.0 – Long-Term Remission Monitoring: regular check-ins for people in stable recovery, much like ongoing care for any long-term health condition.
- Level 1.5 – Outpatient Therapy: counseling and therapy, generally fewer than 9 hours a week for adults.
- Level 1.7 – Medically Managed Outpatient: medical care in an outpatient setting, including medication for addiction and management of mild withdrawal.
In the third edition, all of this fell under a single Level 1 – Outpatient Services, with 1-WM for outpatient withdrawal management. You may still see those older labels while states and insurers update their rules.
Not sure if outpatient care is enough? Call (877) 847-2855 to talk through options and check your insurance benefits. It's free and confidential.
Who is outpatient treatment for?
A clinical assessment helps decide if outpatient care is right. It is often a good fit for people who:
- Have a mild to moderate substance use disorder
- Are medically stable and not at risk of severe withdrawal
- Have a safe home and supportive people around them
- Are stepping down from intensive outpatient care or a residential program
- Need ongoing medication-assisted treatment (MAT), which combines FDA-approved medications with counseling
Outpatient care may not be enough if you've had repeated returns to use, live with people who use, or have serious mental health symptoms. If you drink heavily every day or take benzodiazepines daily, talk to a doctor before stopping. Withdrawal from these substances can be life-threatening and needs medical supervision. If you are in danger, call 911. If you are thinking about suicide, call or text 988, the Suicide & Crisis Lifeline.
What does outpatient treatment look like?
There is no single schedule, but a typical week might include:
- One individual therapy session, often using cognitive behavioral therapy (CBT) or motivational interviewing
- One group session, focused on relapse prevention, coping skills or peer support
- A medication visit, if you take buprenorphine, naltrexone or another medication
- Optional family sessions, which help loved ones learn how to support you
Many outpatient services are available in the evening or by telehealth, so you can keep working. If you take methadone for opioid use disorder, you'll receive it through a certified opioid treatment program. Learn more about methadone clinics.
Outpatient care is offered by many kinds of providers, including:
- Licensed addiction counselors, therapists and psychologists
- Community behavioral health centers, which often accept Medicaid
- Primary care doctors and other clinicians who prescribe buprenorphine or naltrexone
- Hospital-based or private outpatient addiction programs
People with a mental health condition as well as a substance use disorder do best when both are treated together. Look for providers that offer dual diagnosis treatment.
How long does outpatient treatment last?
Outpatient care often lasts several months, and many people stay in some form of care for a year or more. Medication for opioid or alcohol use disorder can continue as long as it helps.
The National Institute on Drug Abuse (NIDA) reports that staying in treatment long enough is critical and that most people need at least three months of treatment to significantly reduce or stop drug use. NIDA also notes that recovery can be a long-term process and that treatment plans should change as your needs change. See how long rehab lasts.
How does outpatient care compare with other levels?
| Level of care | ASAM level (4th ed.) | Typical hours | Medical services | Best fit |
|---|---|---|---|---|
| Intensive outpatient (IOP) | 2.1 | About 9 to 19 hours a week | Access to a prescriber | Needs more structure, stable home |
| Medically managed outpatient | 1.7 | Scheduled medical visits | Medication and mild withdrawal care | Needs medication management |
| Outpatient therapy | 1.5 | Fewer than 9 hours a week | As needed | Mild to moderate SUD or step-down care |
| Long-term remission monitoring | 1.0 | Periodic check-ins | As needed | Stable, long-term recovery |
Does insurance cover outpatient treatment?
Under the Affordable Care Act (ACA), substance use disorder services are an essential health benefit for Marketplace and most individual and small-group plans. The Mental Health Parity and Addiction Equity Act (MHPAEA) generally requires that copays, visit limits and similar rules for these services be no stricter than those for comparable medical care.
Your out-of-pocket costs usually depend on:
- In-network vs. out-of-network providers
- Copays or coinsurance for each visit
- Your deductible and out-of-pocket maximum
- Prior authorization, which is less common for outpatient therapy but may apply to some services
Plans vary by state, employer and plan type (HMO, PPO or EPO). Medicaid and Medicare both cover outpatient substance use treatment, though details vary. If you are uninsured, many community programs offer sliding-scale fees or state-funded care. Outpatient care is usually the least expensive level, but costs vary widely.
How do you choose a good outpatient program?
Look for:
- A state license for outpatient substance use treatment, or individual clinicians licensed in your state
- Accreditation from The Joint Commission or CARF (Commission on Accreditation of Rehabilitation Facilities) for programs
- Evidence-based therapies and support for medication
- Clear communication about fees, schedules and what to do in a crisis
Be cautious of:
- Patient brokering, where someone is paid to refer you. This is illegal under the federal Eliminating Kickbacks in Recovery Act of 2018 and many state laws.
- "Free rent" sober homes or free travel offered if you attend a specific program
- Programs that bill for frequent, costly drug tests without explaining why
- Providers who won't share license or credential information
See our guide on how to choose a rehab for more questions to ask.
What happens after outpatient treatment?
As you grow stronger in recovery, sessions usually become less frequent. Many people move to long-term remission monitoring, continue medication, and stay connected through peer support groups. If you face new stress or a return to use, you can step back up to a more intensive level at any time.
Stepping up is not a failure. Substance use disorders are chronic, treatable conditions, and adjusting the level of care to match how you're doing is a normal part of recovery.
To find outpatient programs near you that accept your insurance, call (877) 847-2855 to reach our admissions helpline. It's free and confidential.
