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.