Effective 3/1/26: New Prior Authorization Requirement for MHR/MHTCM Services

Date: 12/05/25

Effective March 1, 2026, Superior HealthPlan will require prior authorization for Mental Health Rehabilitative Services and Mental Health Targeted Case Management (MHR/MHTCM) services for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members. Requests for services will be reviewed for medical necessity per clinical policy.

For MHR/MHTCM services on and after March 1, 2026, prior authorization is required for the following procedure codes. See tables below for each Medicaid and CHIP plan:

Applicable Plan: Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS)

Procedure Code	Description	Criteria
H0034	Medication Training and Support	Clinical Policy: TX.CP.MP.544 Mental Health Rehabilitation and Targeted Case Management (MHR/TCM) Services
H0034 Modifier – HA	Individual Services for a Child/Youth
H0034 Modifier – HQ	Group
H2014	Skills Training and Development
H2014 Modifier – HA	Individual Services for a Child/Youth
H2014 Modifier – HQ	Group
H2017	Psychosocial Rehabilitation
H2017 Modifier – HQ	Group
T1017 Modifier – HA	Individual Services for a Child/Youth
T1017 Modifier – TF	Routine Case Management
T1017 Modifier – TG	Intensive Case Management

Applicable Plan: CHIP

Procedure Code	Description	Criteria
H2014	Skills Training and Development	Clinical Policy: TX.CP.MP.544 Mental Health Rehabilitation and Targeted Case Management (MHR/TCM) Services
H2014 Modifier – HA	Individual Services for a Child/Youth
H2014 Modifier – HQ	Group

To verify prior authorization requirements for specific procedure codes providers can also use Superior’s Pre-Auth Needed Tool below:

Medicaid and CHIP Prior Authorization webpage

Beginning February 1, 2026, prior authorization requests will be accepted for MHR/MHTCM services March 1, 2026, and after.

Prior authorization requests may be submitted through one of the following methods:

· Electronically/Online:

Phone:
- 1-800-218-7508
Fax:
- 1-800-690-7030
- Availity Essentials Portal
- Superior’s Secure Provider Portal

Please note: For patients in a current plan of care extending into and after March 1, 2026, please ensure prior authorization requests are submitted in advance of this date.

Any MHR/MHTCM service billed for a service date March 1, 2026 and later, that does not have an associated authorization approval from Superior, will be denied upon receipt of the claim.

For questions or additional information, contact Superior’s Prior Authorization department at 1-800-218-7508.