Medical necessity criteria updates posted for 2025-2026

The 2025-2026 Magellan Care Guidelines became effective Nov. 8, 2025. 

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 national and plan/program-specific information.