The HCA-61 is the Oklahoma Health Care Authority's prior authorization request for SoonerCare physical, occupational and speech therapy. It reaches clinicians because the therapy provider must attach a signed and dated prescription or order from the referring provider. OHCA requires medical records with every request, and the form warns that missing records may lead to cancellation or denial.
The rendering therapy provider completes the form, including referring and rendering provider NPIs and OHCA IDs, diagnosis codes, the date span, visits, session length and billing codes. The referring physician or other prescriber supplies the signed and dated order that goes with it.
Download the current version from the source each time; forms change without notice.
Therapy Prior Authorization Request Form
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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Complete medical records, specifically the therapy evaluation, the Parental Consent Form SC-15, a signed and dated provider prescription or order, and the Change of Provider Form SC-16 when the member is switching providers. The form warns that submitting it without complete records may result in cancellation or denial.
No. The form asks the provider to check one service type only, and separate authorization requests are required for physical therapy, occupational therapy and speech therapy. Each request lists its own date span, anticipated number of visits, session duration in minutes and codes with units and modifiers.