Clinical Resources for Behavioral Health Providers
Guidelines and Policies
- Clinical Criteria and Guidelines
Includes ASAM Criteria, LOCUS, CALOCUS-CASII, ECSII Criteria, Medicare Criteria, State and Contract Specific Criteria, as well as Optum Behavioral Clinical Policies and Supplemental Criteria. - Reimbursement Policies
- Clinical Practice Guidelines
Guidance about evidence-based practices adopted from nationally recognized entities such as by the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, and the American Society of Addiction Medicine.
Behavorial Health Toolkits
Provider Training Materials
Network Provider Manuals
Prior Authorization
Resources for Patient Care
Medication Resources
- Position statment on evidence-based treatment adopted by the Federation of State Medical Boards in April 2024
- Genoa Medication Management
- Long-Acting Injectable (LAI) Medication
- Long-Acting Naltrexone for AUD
- Medications for Alcohol and Opioid Use Disorder (MAUD / MOUD)
- Spravato FAQs
- Spravato FAQs – Harvard Pilgrim Specific
- Spravato Overview and FAQs – Western Health Advantage
Note: Optum policies may use CPT, HCPCS, specialty society edit standards, or other coding methodologies from time to time. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement.