Superior Prior Authorization Guide

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.

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Navigate to [https://www.superiorhealthplan.com/newsroom/eff-03012026-new-pa-req-for-mhr-mhtcm-services-12052025.html#:\\\~:text=Effective March 1%2C 2026%2C Superior,%2C STAR%2BPLUS) and CHIP members](https://www.superiorhealthplan.com/newsroom/eff-03012026-new-pa-req-for-mhr-mhtcm-services-12052025.html#:%5C~:text=Effective%20March%201%2C%202026%2C%20Superior,%2C%20STAR%2BPLUS\)%20and%20CHIP%20members) **Please ensure you carefully review all Superior authorization requirements.**

Please follow the example provided for Superior Health Prior Authorization:

***Here is a blank copy of the Superior Prior Authorization Form:*** <https://www.superiorhealthplan.com/content/dam/centene/Superior/Provider/PDFs/SHP_20174209C-Behavioral-Health-TX-Standard-PA-Request-Form-P-04092018.pdf>

The Allocation of Units Charts are based on the Texas Resilience and Recovery Utilization Management Guidelines published by the Texas Health and Human Services Commission: - Texas Resilience and Recovery Utilization Management Guidelines:\ Child and Adolescent Services - Texas Resilience and Recovery Utilization Management Guidelines:\ Adult Mental Services similar to Texas Children's Health Plan

Allocation of Units for Adult Mental Health Services

Allocation of Units for Children and Adolescent Mental Health Services

**Documentation Required for Superior Health Prior Authorization:** 1. Superior Health Prior Authorization Form 2. CANS/ANSA Assessment 3. Treatment Plan

**Corporate will receive all authorization correspondence and will forward any incoming approved, denied, or general correspondence as it is received. Please feel free to reach out to the Administrative Department if you have not received an approval within 7 business days.**