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Maryland 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 Plan Forms

Psychological Testing Request Forms

Transcranial Magnetic Stimulation (TMS) & Electroconvulsive Therapy (ECT) Forms

Uniform Treatment Plans (UTP) Fax completed UTP forms to 1-877-235-9905

The UTP should be used for commercial, fully insured members sitused in Maryland.