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 Transparency Tool. To access the tool on our website, log in and go to Clinical Resources>Coverage Criteria & Guidelines>InterQual Criteria & SmartSheets. Then click Go Now.
| 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)
