Medical necessity criteria updates posted in October

The 2024-2025 Magellan Care Guidelines became effective Nov. 2, 2024. 

Magellan uses the most recent 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 national and plan/program-specific information.