August 2025 Top of Mind

National Network updates: effective Oct. 1, 2025

There’s a mid-year update to the National Network Manual for Optum Behavioral Health providers. Although the changes aren’t effective until Oct. 1, you can get a head start by reviewing them now. And remember to replace previous downloaded versions with the updated manual.

Check out some of the key changes:

New items

• Added Individual and Family Plan (Exchange) appointment wait time standards
• Added guidance on discharge planning for inpatient psychiatric facilities and units
• Expanded information and guidance for the HEDIS measures on follow-up care after an emergency room visit or hospitalization for behavioral health, including the timeline for outpatient follow-up appointments after discharge

Updated information

• Clarified reimbursement for outpatient behavioral health services rendered by unlicensed practitioners working towards clinical licensure or other practitioners not eligible to practice independently
• Updated contact information for the Optum Provider and Network Integrity department
• Added more details around collaboration and utilization management in the Outpatient Care Engagement program
• Expanded guidance around discharge planning from inpatient psychiatric hospitals, including the requirement to provide notice of anticipated discharge 24 hours in advance, and the need to have follow-up appointments scheduled prior to discharge and for the appointments to be within 7 days of discharge

See the Change Index on page 2 of the network manual for details.

Questions? 

Call Provider Services at 1-877-614-0484