This is the Magellan website for behavioral health providers
Magellan Health

Texas

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.

Applied Behavior Analysis

Applied behavior analysis (ABA) coding changes, effective Jan. 1, 2019

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