Effective January 1, 2024, PacificSource plans will require prior authorization for the behavioral health services below.
Codes covering Applied Behavioral Analysis (ABA) services include:
- 97151
- 97152
- 97153
- 97154
- 97155
- 97156
- 97157
- 97158
- 0362T
- 0373T
Codes covering neuropsychological and psychological testing include:
- 96130
- 96131
- 96132
- 96133
- 96134
- 96135
- 96136
- 96137
- 96138
- 96139
Prior authorizations can be submitted via InTouch (preferred) or faxed, using the criteria at our Medical Prior Authorization page. Prior authorization forms are available at our Documents and Forms page.