Idaho Authorization Forms
Commercial and Medicare Plans administered by Optum behavioral do not require prior authorization for routine outpatient services. For Optum Idaho Medicaid, please use that section listed below. 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 (Commercial Providers only. Optum Idaho Medicaid does not require prior authorization for Psychological Testing.)
Transcranial Magnetic Stimulation (TMS) & Electroconvulsive Therapy (ECT) Forms
- TMS & ECT Authorization Request Form (NEW) - electronic submission
Optum Idaho Medicaid Authorization Forms
- Idaho Medicaid Case Management
- Idaho Medicaid CBRS Adult - Use New Skills Building CBRS Form
- Idaho Medicaid CBRS Child - Use New Skills Building CBRS Form
- Idaho Medicaid Extended Psychotherapy
- Idaho Medicaid Family Support
- Idaho Medicaid Peer Support
- Idaho Medicaid Skills Building CBRS