Outpatient Behavioral Health Services

Tufts Health Public Plans - Massachusetts

Outpatient therapy

Authorization is not required for the first 12 outpatient therapy visits per benefit year. These are in addition to psychiatric medication visits, group therapy, psychotherapy for crisis, and collateral contacts, which are also exempt from prior authorization.

If the member needs more than 12 visits, submit an outpatient authorization request via the secure Provider portal or fill out the Behavioral Health – Level of Care Request Form (Standard Form) and fax it to 888.977.0776. Refer to the Guides and Resources Training page for instructions for submitting authorization.

Effective for dates of service on or after January 1, 2021, prior authorization will no longer be required (after 12 visits) for Outpatient Psychotherapy for Tufts Health Direct members.

Acupuncture detoxification and substance use treatment

Please call 888.257.1985 for initial authorization.

Electroconvulsive therapy (ECT)

Prior authorization is not required for electroconvulsive therapy.

Group therapy

Prior authorization is not required for group therapy (90853). This service does not count toward a member’s initial 12 outpatient visits per benefit year.

Additional Information

Fax all behavioral health forms to 888.977.0776.

For additional information refer to the Tufts Health Together and Tufts Health Direct Behavioral Health Prior Authorization (PA) and Notification Grid.

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Behavioral Health Diversity Survey

Your answers to this survey will help us identify behavioral health practitioners who can meet preferences around languages spoken, faith, ethnicity, age, or other demographic characteristics important to the member.

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