Medical necessity criteria updates to occur in fall 2026

The 2026-2027 Magellan Care Guidelines will become effective Oct. 10, 2026. These are now 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.