InterQual 2026 Implementation Provider Notice: Effective 7/6/2026

Date: 06/08/26

Louisiana Healthcare Connections will implement the InterQual® 2026 criteria effective July 6, 2026 for both Physical Health and Behavioral Health utilization management reviews. InterQual criteria are a nationally recognized, evidence-based decision support tool used to guide medical necessity determinations. These criteria are applied as a screening tool and are not intended to replace clinical judgment.

Providers may access the InterQual® SmartSheet(s)™ for Adult and Pediatric procedures, durable medical equipment, and imaging services by logging into the secure provider portal or by contacting Louisiana Healthcare Connections Provider Services.

If you have questions, please contact your Provider Network Consultant or Provider Services.