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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 : 6.16 Psychiatric Services for Hospitals : 6.16.1 Prior Authorization Requirements

Prior authorization is not required for fee-for-service clients who are admitted to psychiatric units in acute care hospitals. Out-of-network admissions require notification within the next business day and submission of clinical information to determine appropriateness for transfer to a contracted facility.
For clients who are 20 years of age and younger, initial admission to a state psychiatric facility or freestanding psychiatric facility may be prior authorized through CCIP for a maximum of five days based on Medicaid eligibility and documentation of medical necessity. Court-ordered services are not subject to the five-day admission limitation.
Refer to:
Section 2.17.3, “Prior Authorization and Documentation Requirements” in the Children’s Services Handbook (Vol. 2, Provider Handbooks) for more information about inpatient psychiatric services.

Texas Medicaid & Healthcare Partnership
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