Please note that Empire no longer requires prior authorization for traditional behavioral health outpatient therapy visits for all fully-insured products including Exchange products. Many of our self-funded groups have also removed review of traditional outpatient therapy visits, however, some groups continue to require a review after a certain number of pass-through visits. With the new calendar year please be certain to verify benefits for new patients to ensure you are aware of any requirements.
Empire has also removed prior authorization requirements for psychological testing (CPT codes 96101, 96102 and 96103) for all fully-insured products including Exchange products. Some self-funded groups continue to require review for this service. Please be certain to verify benefits for psychological testing for new patients to ensure you are aware of any prior authorization requirements.
Partial hospitalization, intensive outpatient, applied behavior analysis, electro-convulsive therapy (ECT), trans-cranial magnetic stimulation (TMS) and ambulatory detoxification services continue to require prior authorization from the first visit.