This chapter explores the game of concurrent treatment planning in the partial hospitalization program (PHP)/intensive outpatient program (IOP) setting, where the clinician has the responsibility for identifying a patient’s treatment progress and documenting the patient’s continued acuity to get more covered days from managed care organizations (MCO). It discusses utilization management, its role in treatment planning and the challenges and tasks of concurrent treatment planning. The typical clinician in a hospital will have a utilization review department staffed by nurses or other clinicians who communicate with the MCO. These utilization reviewers are usually exclusive liaisons between the program or physician and the insurance companies or MCOs. The peer-to-peer review is an exercise of greater MCO scrutiny of whether or not a patient meets the criteria for care. In the PHP/IOP setting, the noncompliant patient at first may look acute because the clinician does not have a baseline.