Massachusetts 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

Emergency Admission Notification Online Form

Psychological Testing Request Forms

Transcranial Magnetic Stimulation (TMS) Forms

Uniform Treatment Plans (UTP)

Online (instructions below), Fax: 844-330-4967, Email: utp-phlp@optum.com

Online (instructions below), Fax: 888-960-8129

Online (instructions below), Fax: 844-330-4967, Email: utp-phlp@optum.com