Optum Behavioral Health

Commercial

ABA billing requirements · Source: Optum Behavioral Health — Provider Express (ABA Prior Authorization)

High confidence

Verified 2026-03-16

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline14 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 6 months

BH carve-out managerOptum

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsASD diagnosis, Functional Behavior Assessment, Baseline data, Measurable goals, Intervention strategies, Caregiver training plan

Progress summary cadenceEvery 6 months

Policy Notes

Optum Behavioral Health (UnitedHealth Group subsidiary) is the behavioral health carve-out manager for UHC commercial, UHC Community Plan, GEHA, and many other plans. ABA prior auth submitted through Optum/ProviderExpress portal. BCBA must be enrolled with Optum. Auth requirements follow the underlying health plan.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Optum Behavioral Health.

Official policy source:Optum Behavioral Health — Provider Express (ABA Prior Authorization)

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Data last verified: 2026-03-16 · Confidence: High · See our methodology

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