The following is a list of items and services that require prior authorization:
Intensive Home-Based Services
Day Treatment Intensive
Day Treatment Rehabilitation
Therapeutic Behavioral Services
Therapeutic Foster Care
Crisis Residential Treatment
Adult Residential Treatment
Indigent/Unfunded Services and Medications
Total standard prior authorization requests received: 1,993
The percentage of standard prior authorization requests that were approved, aggregated for all items and services: 94%
The percentage of standard prior authorization requests that were denied, aggregated for all items and services: 4%
The percentage of standard prior authorization requests that were approved after appeal, aggregated for all items and services: 2%
The percentage of prior authorization requests for which the timeframe for review was extended, and the request was approved, aggregated for all items and services: 0%
Total expedited prior authorization requests received: 0
The percentage of expedited prior authorization requests that were approved, aggregated for all items and services: N/A
The percentage of expedited prior authorization requests that were denied, aggregated for all items and services: N/A
Total standard and expedited prior authorization requests received: 1,993
The average and median time that elapsed between the submission of a request and a determination by the BHP for standard prior authorizations, aggregated for all items and services:
Average: 6 hours and 8 minutes
Median: 35 hours and 27 minutes
The average and median time that elapsed between the submission of a request and a decision by the BHP for expedited prior authorizations, aggregated for all items and services. N/A
Substance Use Disorder Services
The following is a list of all the services that require prior authorizations
SUD Residential 3.1, 3.2 WM and 3.5
Total standard prior authorizations received in 2025: 1,008
The percentage of standard prior authorization requests that were approved, aggregated for all items and services: 98.12%
The percentage of standard prior authorization requests that were denied, aggregated for all items and services: 1.88%
The percentage of standard prior authorization requests that were approved after appeal, aggregated for all items and services: 0%
The percentage of prior authorization requests for which the timeframe for review was extended, and the request was approved, aggregated for all items and services: 0%
Total expedited prior authorization requests received: 0
The percentage of expedited prior authorization requests that were approved, aggregated for all items and services: N/A
The percentage of expedited prior authorization requests that were denied, aggregated for all items and services: N/A
Total standard and expedited prior authorization requests received: 1,008
The average and median time that elapsed between the submission of a request and a decision by the BHP for standard prior authorizations, aggregated for all items and services: N/A
The average and median time that elapsed between the submission of a request and a determination by the BHP for standard prior authorizations, aggregated for all items and services: