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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6 Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.10 Psychiatric Diagnostic Evaluations : 6.10.3 Prior Authorization

6.10.3
Psychiatric diagnostic evaluations performed in the inpatient setting are not limited to once per year, but must be based on medical necessity.
Psychiatric diagnostic evaluations do not require prior authorization when performed in the office, home, nursing facility, outpatient hospital, or other settings.
Additional psychiatric diagnostic evaluations may be considered for prior authorization on a case-by-case basis when submitted with supporting documentation, including but not limited to the following:

Texas Medicaid & Healthcare Partnership
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