Finalizing 2024 InterQual criteria transition

As we announced in May, we updated our authorization tools to 2024 InterQual® criteria on July 15 for the following authorization types:

  • 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

There was a slight delay in updating two authorization types – Acute Adult and Acute Pediatric – which will transition to 2024 InterQual criteria effective August 5.