Medical necessity criteria update on Nov. 14 - Provider Portal
Medical necessity criteria updates to occur Nov. 14
The 2026-2027 Magellan Care Guidelines update on Nov. 14, 2026 (rescheduled from Oct. 10). These are posted on our provider website, MagellanProvider.com.
The 2025-2026 Magellan Care Guidelines will remain in effect until that date.
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.