Behavioral health medical necessity criteria updates available next month on web-DENIS

The Magellan Behavioral Health Medical Necessity Criteria have been updated for 2013 and will be available on
web-DENIS March 1.

The document contains medical necessity criteria for psychiatric and substance abuse treatment, including criteria for medical detoxification, which is considered a behavioral health benefit. However, medical detoxification is considered a medical benefit for Federal Employee Program members.

The new criteria will be effective March 1, 2013.

Please note that the 2013 criteria should be used in tandem with the 2013 Behavioral Health Criteria Application Guidelines.

Health care providers may print or copy the 2013 guides directly from web-DENIS. To access the document, go to
web-DENIS and follow these steps:

• Click on BCBSM Provider Publications and Resources.
• Click on Newsletters & Resources.
• Click on Clinical Criteria & Resources.
• Click on 2013 updated Magellan Behavioral Health Medical Necessity Criteria under Resources.

If you have any questions, call Behavioral Health Services at 313-448-7745.