Medical Necessity Criteria

Magellan is committed to promoting treatment at the most appropriate, least intensive level of care necessary to provide safe and effective treatment to meet the member’s biopsychosocial needs. We apply Magellan Care Guidelines based on the member’s individual needs.

Magellan Care Guidelines for Idaho Behavioral Health Plan - effective January 1, 2025 (Current Version)(PDF)

Note that Magellan’s criteria are available at the link above; however, MCG Care Guidelines® and American Society of Addiction Medicine criteria (The ASAM Criteria®) are not published publicly. To view a copy of a guideline associated with an IBHP member’s clinical review, contact us at 1-855-202-0983.

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