Medical necessity criteria updates to occur in July
The 2020-2021 Magellan Care Guidelines will become effective July 1, 2020. Stay tuned to our provider website, MagellanProvider.com, for its release.
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.