Preauthorization or advance approval is required for any of the following:
(a)
Non-emergent inpatient mental health and substance abuse care including admission of emotionally disturbed children and adolescents to residential treatment centers.
(b)
All admissions to a partial hospitalization program (including alcohol rehabilitation).
(c)
Outpatient mental health visits in excess of 23 per calendar year and/or more than two (2) sessions per week.
(e)
Durable medical equipment with a purchase or total rental price in excess of $2,000.
Code of Federal Regulations
(Authority:
38 U.S.C. 501, 1781
)
Code of Federal Regulations
[63 FR 48102, Sept. 9, 1998, as amended at 74 FR 31374, July 1, 2009]