We're updating to InterQual 2019 for inpatient and behavioral health authorizations starting July 12, 2019
To continue to better serve you while ensuring our members are getting the right care, at the right place, at the right time, we’re updating to InterQual® 2019 on July 12, 2019, for inpatient medical and behavioral health authorizations.
Why are we upgrading to 2019 InterQual?
InterQual’s content has been updated to reflect the most recent evidence and clinical standards.
As a result of this transition, the following InterQual subsets will be updated:
Behavioral Health - InterQual subsets |
---|
Adult and geriatric psychiatry |
Child and adolescent psychiatry |
Substance use disorders |
Procedures
|
Inpatient medical - InterQual subsets |
Level of care (LOC): Acute adult
|
LOC: Acute pediatric
|
LOC: Rehabilitation |
LOC: Subacute/Skilled nursing facility |
LOC: Home care Q&A |
LOC: Long term care acute |
Plan types affected
This update affects inpatient and behavioral health authorizations for all product lines, including commercial group and individual plans, Medicare and Medicaid.
To learn more about the InterQual criteria, visit the Change HealthCare website.