Prior Authorization

A requirement that the treating clinician obtain the payer's approval before providing a service. Under MHPAEA (29 CFR § 2590.712(c)(4)), a prior authorization requirement applied to mental health outpatient services is an NQTL — the payer must demonstrate it applies the same authorization standard to comparable medical/surgical outpatient services. Requiring authorization for therapy while waiving it for physical therapy or specialist visits is a classic parity violation.