Prior authorization requirements for behavioral health services — UnitedHealthcare Community Plan of Arizona Long Term Care
Lists behavioral health revenue and procedure codes that require prior authorization for UnitedHealthcare Community Plan of Arizona Long Term Care Medicaid. Applies to participating and out-of-network providers furnishing behavioral health services to plan members in Arizona.
No material clinical or coverage changes in this revision.
Policy summary & scope
This policy establishes prior authorization requirements for behavioral health services delivered to UnitedHealthcare Community Plan of Arizona Long Term Care Medicaid members, effective March 1, 2025. It lists the behavioral health revenue and procedure codes (including psychiatric/inpatient room and board, therapy and program revenue codes, TMS and psychological testing CPT codes, and ABA/habilitation procedure codes) that require prior authorization before services are provided. The policy notes that certain revenue codes must be billed with an appropriate CPT code and that when those CPT codes themselves require authorization, the associated revenue code will also require authorization.
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