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Implementation of the 2018 InterQual Criteria

As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria as a guideline for making medical necessity determinations. Effective November 15, 2018, we will implement the 2018 InterQual criteria in these modules:

  • Acute Adult Criteria
  • Acute Pediatric Criteria
  • Long Term Acute Care Criteria
  • Acute Rehabilitation
  • Subacute & SNF
  • Home Care Criteria
  • Durable Medical Equipment
  • Procedures Criteria
  • Guidelines for Surgery and Procedures Performed in the Inpatient Setting

For more information, contact our Provider Services Helpline at 1-888-991-9023 (M-F, 9:00 a.m. to 5:30 p.m.).