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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
- ABA Assessment Requests - electronic submission (commercial ABA providers only)
- ABA Treatment Plan - electronic submissions
Psychological Testing Request Forms
- Optum Psych Testing Request Form - electronic submission
Transcranial Magnetic Stimulation (TMS) Forms
- TMS Authorization Request Form (NEW) - electronic submission
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.