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Web transcranial magnetic stimulation (tms) & electroconvulsive therapy (ect) forms. Plans administered by optum behavioral do not require prior authorization for routine outpatient services. Authorization (pa) guidelines* to encompass assessment of drug indications, set. View the prior authorization request form for the connecticut, indiana, and ohio market.

Sept 2016 1 Transcranial Magnetic Stimulation (Tms) Initial Authorization Request *Complete.

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Web General Prior Authorization Request Form.

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