Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

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Medical necessity criteria updates to occur in fall 2024

The 2024-2025 Magellan Care Guidelines will become effective later this year. 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 more information.

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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