Medical necessity criteria updates to occur in October
The 2021-2022 Magellan Care Guidelines will become effective Oct. 11, 2021. This is a delay from our regularly scheduled update on July 1 (previously postponed until Sept. 2). Stay tuned to our provider website, MagellanProvider.com, for its release. The 2020-2021 Magellan Care Guidelines will remain in effect until Oct. 10, 2021 this year.
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.