Medical necessity criteria updates to occur in November
The 2023-2024 Magellan Care Guidelines will become effective Nov. 18, 2023. Stay tuned to our provider website, MagellanProvider.com, for its release. The 2022-2023 Magellan Care Guidelines remain in effect until that time.
Magellan uses the MCG Behavioral Health 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.