Texas Prior Authorization Requirements for UnitedHealthcare Exchange Plans
List of behavioral health services and revenue/CPT codes that require prior authorization for participating providers for UnitedHealthcare Exchange plan members in Texas. Applies to inpatient and outpatient behavioral health providers caring for Exchange plan members in Texas.
No material clinical or coverage changes in this revision.
Coverage Criteria
Prior authorization is not required for emergency or urgent care. This exemption applies to participating behavioral health providers treating UnitedHealthcare Exchange plan members in Texas; providers should still reference the member-specific benefit plan document for coverage details.
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