Behavioral health services

This information applies to:

  • Commercial group HMO, EPO, POS and PPO plans
  • Commercial individual MyPriority plans
  • Priority Health Medicare Advantage plans

Behavioral health definition

Behavioral health refers to a continuum of services for individuals at risk of, or suffering from, mental, behavioral, or addictive disorders. Services can be offered by a physician, psychologist or other qualified health professional, either in person or via telemedicine.

Coverage varies by provider and type of service.

Medical policies

Specific authorization & billing information

Notify Priority Health immediately

If you identify a member with any one of these indicators, contact Priority Health Behavioral Health immediately.

  • Overuse or underuse of medical services
  • Non-compliance with treatment plans and/or recommendations
  • Complex medical conditions with psychological/behavioral factors
  • Complex behavioral health conditions with medical factors
  • Inappropriate prescription drug access and use patterns
  • Continuity and coordination of care requiring integrated case management
  • Significant risk management concerns on cases with both behavioral health and medical factors