InterQual® Behavioral Health Criteria

An evidence-based clinical decision support solution for providers who want to empower care managers to make the most appropriate mental health and substance use care decisions.

Evidence-basedcriteria to support behavioral health decisions

Support initial and continued level-of-care decisions

Make better care decisions by consulting behavioral health criteria that address the needs of geriatric, adult, adolescent, and child patients with psychiatric conditions, substance use, or dual diagnoses. 

Help improve patient outcomes

Determine the appropriate level of care by considering functional status, support system quality, and the severity of symptoms or behaviors in the context of patient-specific variables. 

Streamline workflow

See all levels of the care continuum at once with episode-day timeline guidance for each patient and condition, plus guidance for safe movement to alternate levels of care.

Drive consistent, objective decision-making

Equip reviewers to place patients in the most appropriate level of care by giving care managers, utilization reviewers, and providers a common language and standardized decision paths. 

What's included

  • Expert-guided criteria

    • Adult and Geriatric Psychiatry
    • Child and Adolescent Psychiatry
    • Substance Use Disorders
    • Behavioral Health Services


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