Q: Do I need prior authorization to start therapy?
A: Usually not. Routine outpatient therapy on most California plans requires no referral and no prior authorization — you can book directly with an in-network therapist. Where authorization does appear: psychological testing, intensive programs (IOP/PHP), and some out-of-network arrangements. Plans also can't use authorization games to dodge the timely access clock — an urgent appointment requiring prior auth must still happen within 96 hours.¹
Worked example: a scheduler says "we need an auth on file first, call back in three weeks." That's a stall, not a rule. Ask: "Is prior authorization actually required for CPT 90834 on my plan? If so, please start it today — the timely access standard still applies."
Do this: book directly with in-network therapists; make the plan prove any authorization claim in writing.
Source: 1. 28 CCR §1300.67.2.2(c)(5)(B) — law.cornell.edu.