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Behavioral Health Prior Authorization

Kentucky Medicaid·KY · Psychiatry·Prior Authorization
Effective date
Jun 25, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Kentucky Medicaid is rescinding their March 2025 letter that would have resumed prior authorization for behavioral health services on May 1, 2025. Instead, House Bill 695 requires reinstatement of all behavioral health prior authorization requirements that were in place on January 1, 2020, effective June 25, 2025.

Action Required

Action needed
By May 25, 2025: Contact your Kentucky Medicaid MCO (Aetna, Humana, Passport by Molina, UnitedHealthcare, or WellCare) to understand which behavioral health services will require prior authorization starting June 25, 2025. Billing team must update systems to require prior auth for affected behavioral health codes based on MCO requirements. Attend MCO training sessions on the prior authorization process. Update encounter forms and EMR templates to remind providers of prior auth requirements.

Affected Billing Codes

H2027
H0038