Behavioral Health Services

Even Better Together

Virginia Premier Medicaid became a part of Optima Health on July 1, 2023. We are still committed to you and continuing to service all your healthcare needs.  

icon of phone
For general behavioral health questions or authorization requests, please call our dedicated Behavioral Health Authorization line toll free at 1-855-214-3822.

ARTS and Community Mental Health Services

To find out more about Addiction and Recovery Treatment Services (ARTS) and Community Mental Health Services (CMHS), please
visit the ARTS/CMHS provider page.

Medicare Advantage Plan

Behavioral health and substance abuse services for Virginia Premier Medicare Advantage will be authorized and managed by the Virginia Premier Behavioral Health Utilization Review team. Medicare covers traditional services for behavioral health and substance abuse treatment. Traditional services are defined as inpatient and outpatient services at the individual and group levels of care. Services can be obtained via: 

Phone: 1-855-214-3822
Outpatient Fax: 1-804-343-0304
Inpatient Fax: 1-804-799-5105
Web Portal
Virginia Premier bases all service determinations on medical necessity/level of care (LOC) criteria.

For additional information regarding Medicare coverage for behavioral health and substance abuse services go to:

Behavioral Health Service Authorization Requests

Service authorization forms for ARTS and CMHS are accessible on the Department of Medical Assistance Services Webpage:

In the grid of CMHRS services below:

A indicates a service that requires an authorization

R indicates a service that requires a registration

Trauma-Informed Care

Virginia Premier expects all services be provided to members through a trauma-informed care treatment modality. It is important to be aware of the potential impact trauma can have on those we serve, to offer trauma specific services when needed, and to be mindful of trauma-informed interventions.

Providers should follow these core principles of a trauma-informed approach to care: 

  1. Patient empowerment: Using individuals’ strengths to empower them in the development of their treatment
  2. Choice: Informing patients about treatment options so they can choose the options they prefer
  3. Collaboration: Maximizing collaboration among health care staff, patients and their families in organizational and treatment planning
  4. Safety: Developing health care settings and activities that ensure patients’ physical and emotional safety
  5. Trustworthiness: Creating clear expectations with patients about what proposed treatments entail, who will provide services, and how care will be provided

Childhood trauma, if not recognized or left untreated, can result in significant behavioral, physical (medical) or substance abuse problems. Recognizing trauma can be a key factor in prevention. Learn more about adverse childhood experiences (ACEs) and how to address them.

* For More information regarding Behavioral Health Services Coverage please read our Provider Manual chapter on Mental Health Services.

Behavioral Health Services Administrator (BHSA)

Magellan of Virginia serves as the behavioral health services administrator (BHSA) for Virginia Premier and is responsible for the management and administration of the behavioral health benefit programs under contract with DMAS.

Magellan works with:

  • individuals receiving fee-for-service Medicaid benefits
  • children receiving any Medicaid benefit in need of residential treatment services (including therapeutic group homes)

For more information about Magellan of Virginia, please contact them at 800-424-4536 or

Community Mental Health Rehabilitation Services
Procedure Code
Registration vs Authorization Initial Request
Registration vs Authorization Continued Stay Request
Mental Health Case Management (MH CM)
Therapeutic Day Treatment (TDT) for Children
H2016 UG, U7
Mental Health Partial Hospitalization Program (MH-PHP)
Assertive Community Treatment (ACT)
H0040 U1-U5
Mental Health Skill-Building Services (MHSS)
Intensive In-Home
Psychosocial Rehab
Mental Health Peer Support Services-Individual
Mental Health Peer Support Services-Group
Mental Health Intensive Outpatient Services (MH-IOP)
Psychotherapy for Crisis provided for a member in MH-PHP
90839 90840
Multisystemic Therapy (MST) (effective 12/1/21)
Functional Family Therapy (effective 12/1/21)
Mobile Crisis Response (effective 12/1/21)
No continued stay
Community Stabalization (effective 12/1/21)
23-Hour Crisis Stabalization (effective 12/1/21)
No continued stay
Residential Crisis Stabilization Units (effective 12/1/21)
Applied Behavior Analysis (effective 12/1/21)
97153-97158 0373T


By logging in to this portal, I affirm that I have read, understand and agree to abide by the following terms and conditions: 

I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services.

With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. This includes full compliance with the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’), the HITECH Act, and the Virginia Health Records Privacy Act, and applicable regulations to these laws.

I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members.

I agree to notify Virginia Premier System immediately in the event that my network access has been compromised in any way and in the event of unauthorized use or disclosure of any information obtained from the Virginia Premier System network.

Need to register for a new account? Click here.

In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. If you would like access to a specific group NPI/API instead, please enter it in the field provided. 

For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account.

You will receive an email within 3-5 business days with your username and temporary password.

Please call Technical Support for help with Virginia Premier’s Provider Portal at 1-877-814-9909 or email 

Virginia Premier is offering EFT services through PaySpan.

Please click here to sign-up

If you have questions or need help please, contact our Provider Services department at or by calling 804-968-1529.