Transcription of Services that require precertification* or authorization ...
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D (3/17) health precertification list Services requiring precertification*/authorizationBehaviora l health Services requiring precertification/ authorization **This applies only to Services covered under the member s benefits plan. Inpatient admissions Residential treatment center (RTC) admissions Partial hospitalization programs (PHPs) Intensive outpatient programs (IOPs) Psychological testing Neuropsychological testing Outpatient detoxification Applied behavior analysis (ABA) Transcranial magnetic stimulation (TMS) (effective November 1, 2016) * The term precertification means the utilization review process to determine whether the requested service or procedure meets the company s clinical criteria for coverage.
Choice, Aetna HealthFund PPO, Aetna Medicare, Aetna Open Access Managed Choice, Aexcel and QPOS benefits plans may include the option for members to elect to go outside the network and receive reduced benefits. † Aexcel is not available with HMO plans. The Aexcel designation is only a guide to choosing a physician. Members
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