Medical necessity criteria updates posted in October
The 2021-2022 Magellan Care Guidelines became effective Oct. 11, 2021.
Magellan uses the most recent edition of the MCG Guidelines® (“MCG”) in addition to Magellan’s proprietary clinical criteria (“Magellan Healthcare Guidelines”) as the primary decision support tools for its Utilization Management Program.
Note that criteria for some levels of care, plans and states differ. Please visit our Medical Necessity Criteria webpage for more information.