Portion of 2024 InterQual criteria delayed

As we shared in May, we’re transitioning to 2024 InterQual® criteria on July 15. Part of that transition is delayed.

The previously announced change to inpatient acute adult care and acute pediatric care is on hold. The following authorization types were updated to the 2024 InterQual criteria on July 15:

• Level of care (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

As always, we’ll keep you informed when other criteria are set to change.

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