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What is the prior approval criteria for mental health services provided by allied professionals?

Prior approval requests must be accompanied by:

  1. A letter from a physician that indicates the diagnosis and referral for assessment / psychotherapy / counselling therapy and
  2. the Initial Assessment report.

The Initial Assessment can be conducted upon referral from a physician and must include a:

  • clinical interview,
  • brief psychometric screening (where appropriate) and
  • a report to the IFHP indicating a treatment plan and expected duration of treatment (if applicable).

This assessment can be billed to a maximum of 2 hours. The provider should not proceed with further treatment until they get prior approval.

For more information, refer to the IFHP Supplemental Benefit Grid (PDF, 484 KB), Note 2.

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