InterQual® Level of Care Criteria

Assess the safest and most efficient care level based on severity of illness, comorbidities, complications, and the intensity of services being delivered.

Evaluate the Appropriateness of Patient Care Across the Continuum

InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to cost-effectively improve outcomes. The unique episode-day structure helps evaluate whether a patient is responding as expected and recommends interventions in the event of complications or a slower-than-expected response to treatment, as well as next steps for early responders.

Our novel approach involves evaluating Severity of Illness along with Intensity of Service to provide a clinically specific methodology for stay determinations. Additionally, only InterQual has incorporated management of comorbid conditions upon admission, along with continued stay.

InterQual Level of Care Criteria are available for:

  • Acute Adult
  • Acute Pediatric
  • Acute Rehabilitation
  • Long-Term Acute Care
  • Subacute and Skilled Nursing
  • Home Care
  • Outpatient Rehabilitation and Chiropractic

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