Behavioral Health Prior Authorization Requirement Removed (H0023 and H0006)

Update #: OPSBHPA070124
Effective Date: July 1, 2024
Current State: Authorization Required
Future State: Authorization Requirement Removed
Business Owner: Government Behavioral Health - Clinical Implementation

Effective July 1, 2024, Sentara Health Plans will no longer require prior authorization for:

•  Mental Health Case Management (H0023)
• Substance Use Case Management (H0006)

Existing restrictions related to these services continue to apply. For example, these services can only be claimed once per month, and providers can only claim one or the other in a single month. For additional information related to case management billing and utilization of services, please reference the DMAS manual(s).

Download and Print:

Behavioral Health Prior Authorization Requirement Removed (H0023 and H0006)