We’re transitioning to InterQual® 2020
To continue to better serve you while ensuring our members are getting the right care, in the right place, at the right time, we’re updating to InterQual® 2020 on September 14, 2020 for inpatient and outpatient medical and behavioral health authorizations.
Why are we updating to 2020 InterQual?
InterQual’s content has been updated to reflect the most recent evidence and clinical standards.
As a result of this transition, certain types of determinations will be based on modifications to InterQual 2020 criteria, as shown in the table below:
|Authorization||Modified InterQual criteria for:|
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.