Behavioral Health in Massachusetts

Tufts Health Public Plans

Covered services and benefits

Please refer to the following resources for additional information on covered behavioral health services, including prior authorization procedures:

• Outpatient services
• Emergency services
• Diversionary services
• Inpatient services

For more details, please refer to the Tufts Health Public Plans Provider Manual.

In-network

Prior authorization is not required for visits to in-network, outpatient behavioral health providers. Use the Find a Doctor, Hospital, or Pharmacy tool to verify if a provider is considered in-network.

Out-of-network

Prior authorization is required for visits to out-of-network behavioral health providers. Multiple factors are considered when reviewing prior authorization requests, including access and availability of care. Providers can request prior authorizations by submitting the appropriate prior authorization request form or calling 888.257.1985.

Our coordination of benefits and third-party liability policy

The Coordination of Benefits and Third-party Liability Payment Policy is applied to all behavioral health services with the exception of intensive care coordination (ICC) and family support and training (FS&T).

Fax number

Please fax all behavioral health forms to 888.977.0776.