Change Healthcare, an independent company, made updates to the InterQual® Criteria for 2022. On July 28, 2022, a Provider News Center article was published communicating that, in New Jersey, AmeriHealth Insurance Company of New Jersey and AmeriHealth HMO. Inc. (collectively, AmeriHealth New Jersey) would begin using the 2022 InterQual® Criteria on August 27, 2022.
To clarify, this notification also applied to AmeriHealth HMO, Inc. in Pennsylvania (AmeriHealth Pennsylvania), which began using the same updated InterQual® Criteria on August 27, 2022.
The 2022 InterQual® Criteria is used for the review of adult acute care, pediatric acute care, long-term acute care, acute rehabilitation, home care, outpatient rehabilitation, and selected inpatient procedures.
For more information, view a summary of the changes for AmeriHealth New Jersey and AmeriHealth Pennsylvania.
To learn more about the InterQual® Criteria, please visit the Change HealthCare website.