Milliman Care Guidelines

MCG behavioral health
criteria analysis.

CriteriaIQ analyzes your Kipu patient chart against Milliman Care Guidelines for behavioral health — covering Residential, PHP, and IOP levels of care for initial and concurrent review.

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MCG Coverage

Three levels of care.
Initial and concurrent.

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MCG Residential
Milliman MCG Mental Health Residential criteria analysis. SI/IS domain scoring with explicit point rubric. PHQ-9 and GAD-7 integrated automatically.
🏥
MCG PHP
MCG High-Intensity Outpatient Program (PHP) criteria. Initial and concurrent review with MCG-specific medical necessity documentation.
🧹
MCG IOP
MCG Intensive Outpatient Program criteria. IOP-specific intensity of service documentation against Milliman guidelines.
MCG-Specific Features

Built for how MCG
actually works.

  • SI/IS domain scoring with explicit point rubric for residential criteria
  • PHQ-9 and GAD-7 scores automatically integrated from Kipu assessments
  • MCG-specific medical necessity narrative for each level of care
  • Concurrent review trajectory scoring with response to treatment
  • Discharge barrier documentation against MCG continued stay criteria
  • Phone review scripts organized by MCG criteria domains
  • Appeal letters citing specific MCG guideline criteria
Available on Professional Plan

MCG analysis is available on the Professional plan ($199/seat/month) and Enterprise plan ($699/facility/month), alongside full ASAM and InterQual coverage.

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