This is the Magellan website for behavioral health providers
Magellan Health

Texas

For the latest information on flexibilities and extensions due to COVID-19, refer to the Texas Medicaid & Healthcare Partnership and Texas Health and Human Services Commission websites.

Quick reference guides

Texas State Bill 1742: Preauthorization requirements

Preauthorization requirements for Blue Cross and Blue Shield of Texas commercial plans (PDF)

Magellan's annual preauthorization report for BCBSTX commercial plans (PDF) 

Texas House Bill 3041: Renewal of a preauthorization

Provider bulletin regarding Texas HB 3041 (PDF)

Magellan uses ASAM criteria in Texas

In Texas, Magellan uses the American Society of Addiction Medicine (ASAM) criteria as the basis for the utilization reviews of substance use disorder cases.

Standard Prior Authorization Request Form for Health Care Services

Healthcare providers may submit their requests for prior authorization of healthcare services to Magellan using the “Texas Standard Prior Authorization Request Form for Health Care Services.”

The Texas Department of Insurance developed the form to be used to request prior authorization for services for commercial insured members, Medicaid, Medicaid Managed Care, the Children’s Health Insurance Program (CHIP), plans covering employees of the state of Texas, school districts, and the University of Texas and Texas A&M systems.

Please select the appropriate version of the form below based on the members you serve. 

Providers may continue to call Magellan with their prior authorization requests, as the form does not replace other existing methods of contacting Magellan to request a prior authorization. However, if a provider wishes to request a prior authorization by mail or fax using a form, it must be this form as prescribed by the Texas Department of Insurance.

For preauthorization of psychological testing, in addition to the “Texas Standard Prior Authorization Request Form for Health Care Services,” Magellan also requires the provider to complete and submit the “Request for Psychological Testing Preauthorization” form found on our clinical forms page.

Upon receipt of the completed form(s), Magellan will begin the prior authorization process.

The form cannot be used for any other purpose except to request prior authorization of a healthcare service.

You may direct any questions about the form to Magellan at the phone number on the form.

Texas Medicaid

Find plan-specific and program resources for Texas STAR, STAR Kids and CHIP.

Applied behavior analysis

For Texas-specific ABA resources, sign in to this website. 

From the Resources section, select State & Plan Information, then under State-Specific, click the Texas link to access to access the following forms:

  • ABA Provider Orientation
  • ABA Initial Authorization
  • Texas-specific ABA Treatment Plan/Concurrent Review

Anesthesia claims

For dates of service, Jan. 1, 2024 and after, Magellan is longer delegated to pay anesthesia claims on behalf of BCBS TX. Submit all anesthesia claims to the health plan. If you submit an anesthesia claim to Magellan for a date of service Jan. 1, 2024 or after, it will be denied with explanation of payment messaging to resubmit your claim to the health plan.

Submit all anesthesia claims, for dates of service Jan. 1, 2024 and after, directly to BCBS TX using the following address: Blue Advantage, PO Box 660044, Dallas, TX 75266-0044.