Medical necessity criteria updates to occur in November 2024

The 2024-2025 Magellan Care Guidelines will become effective Nov. 2, 2024. Stay tuned to our provider website, MagellanProvider.com, for its release. The 2023-2024 Magellan Care Guidelines will remain in effect until that time.

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.