Priority Health - Auth Requirements Changes for Commercial Substance Use Disorder Outpatient Services

January 6, 2020

Effective Jan. 1, 2020, substance use disorder intensive outpatient services will no longer require authorization or clinical review for commercial members.

 

Why we’re making this change

We’re removing the authorization requirement to improve members’ access to substance abuse intensive outpatient services to ensure they’re able to get the right care at the right time.

 

How services will be monitored

A clinical review process may be initiated for patients with high utilization of outpatient services. Behavioral Health providers will be contacted, and a request will be made to submit clinical documentation for review.