InterQual® Level of Care Criteria

Clinical decision support for providers and payers who want to assess safe and efficient level of care based on illness severity, comorbidities, and complications.


Evidence-basedcriteria to support appropriate patient care

Help improve clinical outcomes

Assess safe and clinically appropriate care level by implementing comprehensive criteria that cover more than 95% of all reasons for admission.

Support quality care

Help improve clinical outcomes in a cost-effective manner by relying on a format that presents evidence-based interventions.

Align care with patient progress

Help improve outcomes by following an episode-day structure with recommended interventions in the event of complications or an accelerated or delayed response to treatment. 

Enhance the patient experience

Transform care by implementing criteria that evaluates severity of illness along with intensity of service to provide a clinically specific methodology for stay determinations.

What's included

  • Available InterQual Level of Care criteria

    • Acute adult
    • Acute pediatric
    • Inpatient rehabilitation
    • Long-term acute care
    • Subacute and skilled nursing
    • Home care
    • Outpatient rehabilitation and chiropractic


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