Behavioral health services

Policies

Call one of the numbers below between the hours of 8:00 AM – 8:00 PM ET Monday through Friday for more information about for our policies for behavioral health benefits.

  • Commercial PPO, POS, Comprehensive, and Traditional members  
    Call 866.322.1657

  • For Commercial HMO, Children’s Health Insurance Program (CHIP) HMO, and Medicare Advantage (BlueJourney PPO and BlueJourney HMO) members 
    Call 800.216.9748

  • For Federal Employee Program (FEP) PPO members (Facility Only) 
    Call 800.356.7986 for Federal Employee Program (FEP) PPO members (Facility Only)

Medical necessity criteria

We use industry standard clinical management criteria to determine medical necessity.

Live training sessions for InterQual Medical Necessity Criteria are available.

Sign up

Preauthorization

In-network providers can request preauthorization through the provider portal.

Providers, both in and out of network, can request preauthorization via phone by calling one of the numbers listed above.

Providers outside of the Capital BlueCross service area requesting services for members should contact their local Blue Plan for preauthorization.

Providers can call 866.688.2242 between the hours of 8:00 AM and 5:00 PM. ET Monday through Friday for all other needs.

Behavioral health services do not require a referral.