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Behavioral Health

We use InterQual® Behavioral Health Criteria as a tool to make medical necessity determinations for certain behavioral health services. The guidelines below are now available in the InterQual Level of Care Criteria application.  To access the InterQual application on our website, log in and go to Clinical Resources>Prior Authorization>InterQual Criteria and SmartSheets. Then scroll down to InterQual Level of Care Criteria.

For Use this InterQual subset
Crisis stabilization Residential crisis.
Family stabilization Intensive outpatient (IOP)*

* If you are looking for Intensive Community Based Treatment (ICBT), please see the ICBT subset.

Related Resources

Medical Policy site
 Payment policies (log in and go to Office Resources>Policies & Guidelines>Payment Policies)