Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. If you need authorization for any of the following services, please select the link below:
Massachusetts Authorization Forms
ABA Assessment & Treatment Plan Forms
- ABA Assessment Requests - electronic submission (commercial ABA providers only)
- ABA Treatment Plan - electronic submissions
Emergency Admission Notification Online Form
Psychological Testing Request Forms
- Optum Psych Testing Request Form - electronic submission
Transcranial Magnetic Stimulation (TMS) & Electroconvulsive Therapy (ECT) Forms
- TMS & ECT Authorization Request Form (NEW) - electronic submission
Uniform Treatment Plans (UTP)
Online (instructions below), Fax: 844-330-4967, Email: utp-phlp@optum.com
Online (instructions below), Fax: 888-960-8129
Online (instructions below), Fax: 844-330-4967, Email: utp-phlp@optum.com