Medical necessity and level of care determination criteria

The Behavioral Health Medical Necessity Criteria and Standards are reviewed annually by the Medical Affairs Committee, a multidisciplinary group of mental health and substance abuse disorder treatment providers. The Behavioral Health Medical Necessity Criteria and Standards were revised in September 2010.

Your agency or facility may request a copy of the Behavioral Health Department Standards and Criteria for Utilization Management. You also can receive answers to questions regarding behavioral health utilization or request a copy of the utilization management criteria by contacting the Behavioral Health department at 800 673-8043 or 616 464-8500.

Topics: Utilization management