Behavorial Health Medical Necessity Criteria

These documents are for Blue Cross Blue Shield of Michigan PPO members or providers. They describe the criteria a patient or provider needs to meet to be approved for tests and procedures related to a behavioral disorder.

If you have a Blue Care Network plan and you're looking for this information, call the behavioral health number on the back of your member ID card.

Current Clinical Criteria

Use these documents for admissions on or after Jan. 1, 2021.


Privacy issues: To report a concern or if you think your protected health information has been compromised, please call us at 1-800-552-8278 or email us. Don't include any protected health information in your email. 

Other issues: For customer service, call the number on the back of your member ID card.