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Michigan Authorization Forms

Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. Optum administers a wide range of benefits. Select your state to locate the appropriate authorization forms.

ABA Assessment & Treatment Plan Forms

Psychological Testing Request Forms

Transcranial Magnetic Stimulation (TMS) & Electroconvulsive Therapy (ECT) Forms

All other Non-Routine Services - Michigan Electronic Submission Form - Commercial providers only

Changes to Prior Authorization

  • If Optum amends prior authorization needs for any commercial MI service, the notice will be posted to this page at least 60 days prior to the change