Kansas Prior Authorization Requirements for UnitedHealthcare Exchange Plans (Behavioral Health)
Lists behavioral health services and procedure/revenue/CPT codes that require prior authorization for participating behavioral health providers for UnitedHealthcare Exchange Plans in Kansas (inpatient and outpatient). Applies to non-emergent services and notes member-specific benefit plan terms vary by state.
No material clinical/coverage changes
Policy Summary
This policy lists behavioral health services and specific procedure/revenue/CPT codes that require prior authorization for UnitedHealthcare Exchange Plans members in Kansas. Effective January 1, 2024, it applies to the inpatient and outpatient services enumerated in the code lists and is current. The rule requires prior authorization for the listed behavioral health services for Exchange Plans members in Kansas, except for emergency or urgent care. Members have no non-emergent out-of-network coverage and no coverage outside of the service area, and coverage decisions remain subject to the member-specific benefit plan terms.
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