May 2026 Top of Mind

Some freestanding psychiatric hospital providers must temporarily call to submit authorizations

With the transition from American Society of Addiction Medicine (ASAM) 3rd to 4th Edition Criteria, some freestanding psychiatric hospitals must temporarily call to request prior authorization instead of submitting through the enhanced process in the Provider Express secure portal.

Who must call for authorization

Freestanding psychiatric hospital providers who meet both of the following criteria must call for prior authorization:

• Have a contract that’s been updated for ASAM 4th Edition Criteria, and
• Are providing services to members with co-occurring mental health and substance use disorders

Next steps

Hospital providers that meet the criteria above must call the number on the back of the member ID card to request prior authorizations. Freestanding psychiatric hospitals whose contracts haven’t been updated, please continue to submit prior authorization requests through the enhanced secure portal process.

We’ll communicate when portal revenue codes and services are updated and affected providers may resume submitting authorizations electronically.

We appreciate your patience and apologize for any confusion, delays or billing errors this may have caused.

Questions?

For more information, please call Provider Services at 1-877-614-0484, Monday–Friday, 7 a.m.–7 p.m. CT. You may also contact your Provider Relations Advocate.