Mental health and substance abuse treatment

• Network Health does not require authorization for the first 26 visits per calendar year.
• If your Network Health patient needs more than 26 visits, please submit the MCO Outpatient Review Form (PDF) at least three weeks prior to the 27th visit.

Acupuncture detoxification

• Call us at 888-257-1985 for initial authorization.

Electroconvulsive therapy

• Call us at 888-257-1985 for initial authorization.

Psychological testing

• Network Health requires prior authorization; please submit the Authorization Request for Psychological Testing Form (PDF)

Group Therapy

• Network Health does not require prior authorization for group therapy (code 90853 – Group Psychotherapy). Group therapy does not count toward a patient’s initial 26 visit per benefit year.

Our fax number

Please fax all behavioral health forms to 888-977-0776.