We’re transitioning to InterQual® 2021 criteria for most inpatient and all post-acute procedures starting Aug. 23, 2021
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 InterQual® 2021 on Aug. 23, 2021 for most inpatient and all post-acute procedures.
Inpatient elective, behavioral health and outpatient procedure InterQual criteria will be updated later this year.
Why are we updating to 2021 InterQual?
InterQual’s content has been updated to reflect the most recent evidence based and clinical standards.As a result of this transition, certain types of authorizations will be based on modifications to InterQual 2021 criteria, as shown in the table below:
|Authorization||Modified InterQual criteria for the following procedures:|
|Inpatient medical & post-acute medical||