Behavioral health resources

If you have questions about behavioral health services, please view the behavioral health Prior Authorization Code by State list.

Optum Behavioral Health uses clinical criteria, based on sound clinical evidence, to make coverage determinations, as well as to inform discussions about evidence-based practices and discharge planning. In using its clinical criteria, Optum Behavioral Health takes individual circumstances and the local delivery system into account when determining coverage of behavioral health services. To learn more about the clinical criteria used by Optum Behavioral Health to make coverage decisions, go to providerexpress.com > Clinical Resources > Guidelines Policies and Manuals > Clinical Criteria. See other resources below.

• TDI Texas Medicaid Prior Authorization Form
• Optum Texas Medicaid Prior Authorization Form for Facility-Based Care
• Optum Online Authorization Training for Behavioral Heath Testing
• Substance use disorder resources (via Provider Express Behavioral Health Toolkit for Medical Providers [providerexpress.com])
• Guideposts for the Treatment of Opioid Use Disorder
• CDC Opioid Use Disorder Training
• Quick Reference Guide for Substance Use Screening Tools

• New Website: Texas Behavioral Health and Justice Technical Assistance Center: The Office of Forensic Coordination at the Texas Health and Human Services Commission is pleased to announce the launch of the new Texas Behavioral Health and Justice Technical Assistance Center website
• Behavioral Health Identification, Treatment and Referral in Primary Care: A 3-Part On-Demand Series: This series discusses the identification, treatment and referral of behavioral health needs in primary care.  Each session is eligible for continuing education credits.
• Texas Medicaid ABA Program: Optum Provider Express has several training resource materials to assist in helping you provide the new autism/applied behavior analysis (ABA) Medicaid-covered services.
• Provider Express Training & Guided Tours: Optum Provider Express for behavioral health offers guided training about prior authorization, eligibility and benefits and claims (claim entry, corrected claims, claim inquiry, etc.). First-time user training is available as well as a technical resource guide.
  • Provider and Staff Toolkits
  • Behavioral Health Toolkit for Medical Providers
  • Guideposts for the Treatment of Schizophrenia
• OptumHealth Education: OptumHealth Education offers accredited, on-demand webcasts and information regarding upcoming conferences for both physical and behavioral health providers. Some activities include disease management, autism spectrum disorder, behavioral health, intellectual and developmental disabilities.
• Deviation Request Process: Training for the online deviation request process through Provider Express

• Health Care Professional Training for Postpartum Depression
• House Bill 12 Summary
• Hear Her Texas: Learn about urgent maternal warning signs and discover how you can help

Clinicians and facilities who see Texas Star or Texas STAR+PLUS members (in the counties of Brazoria, Ft. Bend, Galveston, Harris, Montgomery and Waller) should refer to the following manuals for information specific to that membership:

• Texas Medicaid and CHIP Program Regulatory Requirements
• Optum Behavioral National Network
• Texas Medicaid Prior Authorization Form Fax number: 844-280-1168
• Community Based Service Deviation Request Online Submission Training
• Community Based Service Deviation Request Form

Behavioral Health Toolkit for Medical Providers: Find screening tools, referral options, clinical guidelines, treatment guideposts, training resources and many additional provider resources