AmeriHealth
Upcoming Changes to AmeriHealth Plans
For applied behavior analysis (ABA) services:
All requests should be submitted to Magellan up through and including March 31, 2026. For ABA requests on/after April 1, 2026, contact AmeriHealth at the number on the member’s ID card.
- Exception: AHNJ ABA services will transition from Magellan to AmeriHealth effective Jan. 1, 2026.
For all other behavioral health services:
- For AmeriHealth Administrators, contact the number listed below. These services are currently managed by the AmeriHealth team.
- For AmeriHealth MN, all non-ABA behavioral health services will transition from Magellan to AmeriHealth on Jan. 1, 2026. The effective date and the phone numbers are listed below (and on the back of the member ID card).
|
|
ABA UM/CM Transition Magellan to Independence Effective Date |
All other BH UM/CM Transition Magellan to Independence Effective Date |
Phone |
|
AmeriHealth NJ |
1/1/2026 |
N/A-currently with Independence |
1-800-809-9954 |
|
AmeriHealth Administrators NJ |
4/1/2026 |
N/A-currently with Independence |
1-800-809-9954 |
|
AmeriHealth MN |
4/1/2026 |
1/1/2026 |
1-844-268-2686* |
*Phone number available on/after 1/1/2026.
Applied Behavior Analysis
- For autism-related forms, sign in to this website. From the Resources section, select State & Plan Information, then choose Autism-Specific Information to access:
- ABA Initial Authorization
- ABA Treatment Plan/Concurrent Review
For all other behavioral health requests, contact AmeriHealth at the number on the member’s ID card, except for AmeriHealth Administrators GeoBlue Pennsylvania Commercial plans.
For authorization information for GeoBlue Commercial members, see below.
Pennsylvania
Prior Authorization Process for GeoBlue Pennsylvania Commercial Plans
Medical Necessity Criteria/Medical Policy
Substance use disorder:
- American Society of Addiction Medicine (ASAM) and An Introduction to The ASAM Criteria for Patients and Families (PDF) - Licensee's use and interpretation of the American Society of Addiction Medicine’s ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits.
Applied behavior analysis and psychological testing:
Other mental health services:
- Additional criteria are available here.
Prior Authorization Requirements
Requesting Prior Authorization
Some facility and non-routine outpatient services may be requested online via the Request Member Care application.
- Sign into this website and select Request Member Care from the left-hand menu.
- If the provider portal (Request Member Care app) is not available, you may contact Magellan at 1-800-778-2119 for authorization of services to GeoBlue Commercial members.
Tutorials:
- Request Member Care – Facility services
- Request Member Care – Non-routine outpatient services
User guides:
- Request Member Care – Facility services (PDF)
- Request Member Care – Non-routine outpatient services (PDF)
For services that require prior authorization and are not accessible through the Request Member Care application, complete the appropriate form below and fax it to Magellan.
- For autism-related forms, sign in to this website. From the Resources section, select State & Plan Information, then choose Autism-Specific Information to access:
- ABA Initial Authorization
- ABA Treatment Plan/Concurrent Review
- Psychological Testing Preauthorization Request Form (PDF)
- ECT Authorization Request Form (PDF)
- TMS Authorization Request Form - initial and concurrent (PDF - print for handwritten completion)
- TMS Authorization Request Form - initial and concurrent (Word - download for digital completion)
- Fax number for completed form submissions:
- ABA: 1-888-656-4925
- Psychological testing and ECT: 1-888-656-0259
- TMS: 1-888-656-4967
- Customer service numbers:
- AmeriHealth Administrators GeoBlue: 1-800-778-2119
- Provider Services Line: Chat with us or contact us at 1-800-788-4005 for technical issues with the website.
Requesting a Peer-to-Peer Consultation
To request a peer-to-peer consultation, contact Magellan’s Utilization Management Support Team at 1-800-741-2304, option 3, then Option 2.
- Peer-to-peer process (PDF)
New York
Notice to inpatient providers in New York who serve GeoBlue members, an AmeriHealth Administrators plan (PDF)
State of Washington
Preauthorization requirements for GeoBlue members, an AmeriHealth Administrators plan (PDF)