ABA Assessment & Treatment Plan Preferred Form
ABA Assessment Requests - Electronic submission (commercial ABA providers only)
Massachusetts Authorization Forms
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:
ABA Assessment & Treatment Requests Alternate Forms
- ABA Assessment/Treatment Requests - printable PDF
- 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)
- TMS Prior Authorization Request Process Training
Uniform Treatment Plans (UTP) (For Commercial Plan use only)
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