November 2025 Top of Mind

Jan. 1, 2026: Prior authorizations not required for certain MH/SUD outpatient services

Starting Jan. 1. 2026, prior authorization will no longer be required for certain outpatient mental health and substance use disorder (MH/SUD) outpatient services. As outlined in an amendment to the 2024 Minnesota Omnibus Budget Bill, the changes apply to designated outpatient services delivered in Minnesota by both network (contracted) and out-of-network providers. Here are the details:

Member eligibility
This prior authorization exemption applies to Minnesota residents enrolled in commercial, fully insured and non-ERISA self-funded/ASO health plans. Prior authorization requirements are not changing for Medicare Advantage Plans and commercial ERISA self-funded/ASO health plans.

Services that no longer require prior authorization:

• Partial Hospitalization Program
• Intensive Outpatient Program
• Transcranial Magnetic Stimulation
• Psychiatric Testing
• Applied Behavior Analysis

Note: Prior authorization is still required for certain prescription medications. Neuropsychology Testing currently does not require prior authorization.

What to expect next
Prior to Jan. 1: We’ll continue to process prior authorization requests as usual.

Starting Jan. 1, 2026: If you submit a prior authorization request for any of the services above, we will promptly call or email you to advise that prior authorization is no longer required. If we can’t reach you by email or phone, you’ll receive a letter.

Questions? We’re here to help.
For more information, please email ohbs.centralregion@optum.com or call the number on the back of the member ID card.