Behavioral Health in Massachusetts

Tufts Health Public Plans

Covered services and benefits

Tufts Health Plan covers the following services:

• Outpatient services
• Diversionary services
• Inpatient services
• Intensive Home and Community-based services

For prior authorization and notification details for the services listed above, refer to the Behavioral Health Prior Authorization and Notification Grid for Tufts Health Together and Tufts Health Direct or Tufts Health Unify located in the Provider Resource Center. As a reminder, emergency services are never subject to authorization.

For more information, please refer to the Behavioral Health chapter of 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. For more information, refer to the medical necessity guidelines for Out-of-Network Coverage at the In-Network Level of Benefits (All Plans).

Contact Information

Tufts Health Together and Tufts Health Direct
Fax: 888.977.0776
Phone: 888.257.1985

Tufts Health Unify
Fax: 857.304.6304
Phone: 855.393.3154