We're transitioning to 2023 InterQual® starting July 17

Updated June 1, 2023: InterQual 2023 update will take place on July 17, 2023 rather than July 10.


We’re aligning to nationally recognized standards to ensure our members are getting the right care, in the right place, at the right time by updating to 2023 InterQual® on July 17, 2023.

Why are we updating to 2023 InterQual?

InterQual is nationally recognized as an industry standard for evidence-based medicine criteria, ensuring appropriate care. These criteria are regularly updated to reflect the most recent evidence-based and clinical standards

What authorization types are affected?

As a result of this transition, the following authorization types will be based on modifications to 2023 InterQual criteria:

  • Level of care (LOC): Acute Adult*
  • LOC: Acute Pediatric*
  • LOC: Inpatient Rehabilitation
  • LOC: Subacute/Skilled nursing facility
  • LOC: Home Care Q&A
  • LOC: Long-Term Acute Care
  • CP: Durable Medical Equipment
  • CP: Procedures
  • Medicare: Post Acute & Durable Medical Equipment
  • Medicare: Procedures
  • Behavioral health (BH): Adult and Geriatric Psychiatry
  • BH: Child and Adolescent Psychiatry
  • BH: Substance Use Disorders
  • BH: Services

*Several criteria set revisions based on best practices and available evidence