Effective 1/1/25 Behavioral Health: Substance Use Disorder Treatment Criteria

Date: 10/25/24

Ambetter from Superior HealthPlan will adopt Change Healthcare’s InterQual ASAM Criteria Navigator as the medical necessity review criteria of Substance Use Disorder Treatment for members effective January 1, 2025. Ambetter ensures medical necessity review criteria is current and appropriate for members and the scope of services provided. 

To review prior authorization requirements, please visit Ambetter Authorization Requirements webpage. 

For questions or additional information, contact the Prior Authorization department at 1-877-687-1196.