Texas 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

Psychological Testing Request Forms

Transcranial Magnetic Stimulation (TMS) Forms

Uniform Treatment Plan (UTP)

Fax completed UTP forms to 1-877-235-9905, unless requesting TX SB 58 Services. If requesting TX SB 58 Services, fax completed TX UTP to 1-877-450-6011.